Individual
MACKENZIE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1100
Mailing address
1412 STERLING ST, FORT GIBSON, OK 74434-8252
(918) 348-4422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5721
OK
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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