Mackenzie Annisa Peres
Behavior Technician in Round Rock, TX. Individual provider (NPI-1).
NPI number1124889134
StatusActive
Last updated in NPPESJan 17, 2024
Details
- NPI
- 1124889134
- Entity type
- Individual (NPI-1)
- Name
- Mackenzie Annisa Peres
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 17, 2024
- Certification date
- Jan 17, 2024
- Last updated
- Jan 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2400 S Interstate 35 Ste 190Round Rock, TX 78681
Phone 737-708-8003 · Fax 737-708-8022
Mailing address
2400 S Interstate 35 Ste 190Round Rock, TX 78681
Phone 737-708-8003 · Fax 737-708-8022
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