Individual
MS. MACKENZIE GRACE GAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 427-3700
Mailing address
10 LINCOLN AVE, SMITHTOWN, NY 11787-5530
(631) 352-7465
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
07/12/2023
Last updated
01/22/2026
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