Individual
MACKENZIE LINN WASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 RED MOON CIRCLE, TRIBAL OPIOID RESPONSE PROJECT, CONCHO, OK 73022-7302
(405) 422-7452
Mailing address
100 RED MOON CIRCLE, TRIBAL OPIOID RESPONSE PROJECT, CONCHO, OK 73022
(405) 422-7452
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
D083324170
OK
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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