Individual
TONYA REBECCA MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1411 GRANDVIEW AVE, PORTSMOUTH, OH 45662-3686
(423) 314-5205
Mailing address
1411 GRANDVIEW AVE, PORTSMOUTH, OH 45662-3686
(423) 314-5205
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
OTA.03846
OH
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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