Individual
SHELLEY MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1305 GILL ST, COLUMBIA, MS 39429-2605
(601) 705-1901
Mailing address
1305 GILL ST, COLUMBIA, MS 39429-2605
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M8088
MS
Other
Enumeration date
08/14/2009
Last updated
08/14/2009
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