Individual
MACKENZIE BOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
3230 W WILDWOOD DR, GRAND ISLAND, NE 68801-9609
(308) 381-8851
(308) 381-8853
Mailing address
2931 E BIDDLE ST, BALTIMORE, MD 21213-3939
(443) 923-1872
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1048
NE
Other
Enumeration date
11/19/2013
Last updated
09/01/2023
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