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Individual
MACKENZY RYAN
Active
Individual
MACKENZY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004992
CT
225X00000X
Occupational Therapist
12922
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402411
NBCOT CERTIFICATION #
—
Enumeration date
07/02/2022
Last updated
07/02/2022
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