Individual
MACKENZIE BREITHAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 HALL ST UNIT A, TRAVERSE CITY, MI 49684-2288
(231) 965-3762
Mailing address
105 HALL ST UNIT A, TRAVERSE CITY, MI 49684-2288
(231) 965-3762
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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