Individual
MACKENZIE SHAMBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5103
(580) 548-7003
Mailing address
101 NE 53RD ST APT 2713, OKLAHOMA CITY, OK 73105-1862
(580) 548-7003
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-518325
OK
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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