Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1023475357 |
---|---|
Provider Name | Katherine Mckenzie |
First Address | Melbourne, FL 32934-3236 |
Second Address | Keller, TX 76248-2125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2016 |
Last Update Date | 27/04/2018 |