Individual
MACKENZIE RAFINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
60 W LANDIS AVE, VINELAND, NJ 08360-8132
(585) 285-6772
Mailing address
60 W LANDIS AVE, VINELAND, NJ 08360-8132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649710609
—
NJ
Enumeration date
10/19/2018
Last updated
10/19/2018
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