Individual
MACKENZIE GERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
9111 MONROE RD STE 100, CHARLOTTE, NC 28270-2460
(704) 847-3911
Mailing address
9111 MONROE RD STE 100, CHARLOTTE, NC 28270-2460
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9362
NC
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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