Individual
MACKENZIE RISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 MAPLE AVE, BELLEFONTAINE, OH 43311-1619
(937) 599-1975
(937) 599-2769
Mailing address
PO BOX 817, WEST LIBERTY, OH 43357-0817
(937) 465-8065
(937) 465-0442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1500600
OH
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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