Individual
MACKENZIE MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
207 W GEORGIA AVE, NAMPA, ID 83686-3024
(208) 467-1069
Mailing address
207 W GEORGIA AVE, NAMPA, ID 83686-3024
(208) 467-1069
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TSLP-4408
—
ID
Enumeration date
08/05/2020
Last updated
08/05/2020
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