Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1-21-11859 | FL |
N | 106S00000X | Behavior Technician | RBT-19-91004 | FL |
NPI | 1104487404 |
---|---|
Provider Name | Makenzie Michelle Worthington |
First Address | Pensacola, FL 32514-8124 |
Second Address | Cantonment, FL 32533-7795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 24/02/2021 |