Makenna Rae Stark

NPI #1033817960 in Mt Juliet, Tennessee

Provider Information

NPI Number: 1033817960
Entity Type: Individual
Name: Makenna Rae Stark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 20, 2023
Last Updated: Feb 20, 2023

Practice Location

Address: 1535 N MOUNT JULIET RD
City: Mt Juliet
State: Tennessee
ZIP Code: 37122-3315
Phone: (615) 560-6622

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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