Healthcare Provider Details

I. General information

NPI: 1487560025
Provider Name (Legal Business Name): MAKAYLA ANN CHRISTENBURG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 OAKLAND AVE
ROCK HILL SC
29730-4064
US

IV. Provider business mailing address

609 ANTNEY LN
ROCK HILL SC
29732-9166
US

V. Phone/Fax

Practice location:
  • Phone: 803-415-2435
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1175159
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: