Individual
MACKENZIE CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
405 LOVE AVE, TIFTON, GA 31794-4403
(229) 402-7188
Mailing address
611 W 3RD ST, OCILLA, GA 31774-1737
(229) 425-5769
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011345
GA
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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