Individual
MACKENZIE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68583 SCOTT STREET, BRIDGEPORT, OH 43912
(740) 298-7078
Mailing address
PO BOX 775, BARTON, OH 43905-0775
(740) 298-7078
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-269090
OH
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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