McKenzie Catherine Anderson

Individual provider Active NPI Behavior Technician · Summerville, SC

NPI 1316638752 · NPPES record last updated May 17, 2023

Key facts

NPI
1316638752
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-269617 (SC)
Practice address
328 Glen St
Summerville, SC 29483-4653
Phone
(843) 460-2605
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-23-269617SCMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-269617 SC Yes

Addresses

Primary practice location

328 Glen St
Summerville, SC 29483-4653

Mailing address

328 Glen St
Summerville, SC 29483-4653
Phone (843) 460-2605

Other providers in Summerville, SC

All providers in Summerville, SC · Behavior Technician in South Carolina

Sources for this page

Verify at the official NPI Registry.