Individual
MACKENZIE LEE KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 S GULLEY RD STE F, DEARBORN, MI 48124
(734) 407-2500
(313) 792-8962
Mailing address
3101 S GULLEY RD STE F, DEARBORN, MI 48124-4406
(734) 407-2500
(313) 792-8962
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010654
MI
225XP0200X
Pediatric Occupational Therapist
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—
Other
Enumeration date
11/30/2018
Last updated
09/10/2019
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