Individual
MCKENNA MARIE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6033 FASHION POINT DR STE 100, SOUTH OGDEN, UT 84403-4848
(605) 271-2690
Mailing address
1105 W RUSSELL ST, SIOUX FALLS, SD 57104-1322
(605) 271-2690
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/28/2019
Last updated
04/21/2026
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