Individual
MACKENZIE NUNNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3501 FESTIVAL PARK PLZ, CHESTER, VA 23831-4449
(804) 930-8280
(804) 930-8101
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 580-5222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000512
VA
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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