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Individual

MACKENZIE MINGES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2800 EMERALD WAY, WAYNESVILLE, OH 45068-9586
(937) 409-3710
Mailing address
2800 EMERALD WAY, WAYNESVILLE, OH 45068-9586

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
253Z00000X
In Home Supportive Care Agency
347C00000X
Private Vehicle
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
Primary

Other

Enumeration date
05/05/2021
Last updated
05/05/2021
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