Individual
MACKENZIE JEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
30100 TELEGRAPH RD STE 140, BINGHAM FARMS, MI 48025-4516
(248) 385-0030
(248) 849-9980
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 350-2644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
71091006397
MI
235Z00000X
Speech-Language Pathologist
Primary
71091006397
MI
Other
Enumeration date
03/15/2021
Last updated
03/15/2021
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