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Individual

MS. GARY PAUL MCKENZIE VI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDCII

Contact information

Practice address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
(419) 747-3504
Mailing address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
(419) 747-3504

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
011318
OH

Other

Enumeration date
04/05/2018
Last updated
04/05/2018
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