Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1083957369 |
---|---|
Provider Name | William Mckenzie |
First Address | Oakland, CA 94602-2529 |
Second Address | Oakland, CA 94602-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 04/04/2013 |