Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | MA19924 | FL |
NPI | 1144422767 |
---|---|
Provider Name | Ms. Sandra Mckenzie |
First Address | Tamarac, FL 33321-9006 |
Second Address | Plantation, FL 33322-6548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 08/07/2007 |