Provider Demographics
NPI:1891676276
Name:MCCRACKEN, AKELA RAYNE
Entity type:Individual
Prefix:
First Name:AKELA
Middle Name:RAYNE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 KADISON CT
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-6814
Mailing Address - Country:US
Mailing Address - Phone:573-578-8813
Mailing Address - Fax:
Practice Address - Street 1:1216 KADISON CT
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-6814
Practice Address - Country:US
Practice Address - Phone:573-578-8813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician