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Search › Illinois › 103K00000X

Mckenzie Theisen, BCBA

NPI 1992386007 · on the registry since 2021

Practice

Address
5221 6th Street Frontage Rd E Ste 100
Springfield, IL 62703
Phone
(712) 305-5526
Organisation at this address
Clover Solutions Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
13

Registry record

Primary taxonomy
103K00000X
103K00000X
Also registered as
106S00000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-12-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois