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Individual

MCKENZIE D MACALLISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS OTR/L CPAM

Contact information

Practice address
1715 FRIENDSHIP CIR, CUMMING, GA 30028-6917
(770) 240-0163
Mailing address
51 TIMBER WALK, DAWSONVILLE, GA 30534-5337
(770) 377-5200

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005764
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
315531
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
01
GA005764
GEORGIA SECRETARY OF STATE OCCUPATIONAL THERAPY LICENSING BOARD
GA
Enumeration date
03/08/2021
Last updated
03/08/2021
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