Individual
MRS. MCKENZIE LONG COOMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP, MA
Contact information
Practice address
972 N 1300 W, PLEASANT GROVE, UT 84062-9433
(607) 631-6112
Mailing address
972 N 1300 W, PLEASANT GROVE, UT 84062-9433
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11461472-4102
UT
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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