Individual
MCKENNA GRACE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2316
(479) 967-3639
Mailing address
P.O. DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-230185
AR
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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