Most Relevant Information
Provider Data
| NPI Number: | 1003534579 |
| Provider Name: | ISABELLE JOLIE MACKRELL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-22-9393-428937 |
Most Important Dates
| Enumeration Date: | 08/19/2022 |
| Last Updated: | 08/19/2022 |
Provider Practice Location
5526 N ACADEMY BLVD STE 109
COLORADO SPRINGS
CO
809183688
Practice Location Phone/Fax
| Phone: | 7193015100 |
| Fax: |
Provider Mailing Location
5526 N ACADEMY BLVD STE 109
COLORADO SPRINGS
CO
809183688
Provider Mailing Phone/Fax
| Phone: | 7193015100 |
| Fax: |