Individual
MACKENZIE LYNN FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
W417 SUNSHINE DR, STODDARD, WI 54658-9059
(651) 707-5137
Mailing address
W417 SUNSHINE DR, STODDARD, WI 54658-9059
(651) 707-5137
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4142-226
WI
101YP2500X
Professional Counselor
Primary
8039-125
WI
Other
Enumeration date
04/12/2018
Last updated
05/06/2022
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