Individual
MAKENZE MAGGIE MACKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MENTAL HEALTH P
Contact information
Practice address
2800 FREEWAY BLVD STE 204, MINNEAPOLIS, MN 55430-1751
(763) 412-1996
(763) 292-5653
Mailing address
2800 FREEWAY BLVD STE 204, MINNEAPOLIS, MN 55430-1751
(763) 412-1996
(763) 292-5653
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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