Individual
MACKENZIE BLAKE TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
613 MARQUETTE RD, BRANDON, MS 39042-3038
(601) 825-8800
Mailing address
613 MARQUETTE RD, BRANDON, MS 39042-3038
(601) 825-8800
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C11413
MS
Other
Enumeration date
04/19/2021
Last updated
04/02/2025
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