Individual
MISS MACKENZIE ANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 NE NORTON LN, MCMINNVILLE, OR 97128-8470
(503) 883-8250
(888) 835-4257
Mailing address
2053 N SHEFFIELD AVE APT 4F, CHICAGO, IL 60614-7424
(815) 245-1435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
IL
235Z00000X
Speech-Language Pathologist
Primary
17517
IL
Other
Enumeration date
11/30/2018
Last updated
05/15/2024
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