Individual
MACKENZIE JO RICKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CF-SLP
Contact information
Practice address
1220 LAGUNA ST, KOKOMO, IN 46902-2330
(765) 454-5340
Mailing address
3568 N 100 E, WABASH, IN 46992-7703
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46003286A
IN
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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