Individual
MACKENZIE RAE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 LIBERTY BANK LN STE 230, LOUISVILLE, KY 40222-5756
(855) 444-5664
Mailing address
7513 MANSLICK RD, LOUISVILLE, KY 40214-4141
(502) 602-3223
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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