Individual
MACKENZIE MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IIN
Contact information
Practice address
4204 GEORGIA ST, SAN DIEGO, CA 92103-2519
(206) 375-5204
Mailing address
PO BOX 140427, DALLAS, TX 75214-0427
(206) 375-5204
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/09/2022
Last updated
01/09/2022
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