Individual
MACKENZIE BLAKE TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
197 CHARMANT PL STE 2, RIDGELAND, MS 39157-4352
(601) 707-5550
Mailing address
197 CHARMANT PL STE 2, RIDGELAND, MS 39157-4352
(601) 707-5550
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C11413
MS
Other
Enumeration date
04/19/2021
Last updated
07/31/2026
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