Individual
MACKENZI JOE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1582 N WAGGONER RD, BLACKLICK, OH 43004-8669
(614) 344-0419
Mailing address
1582 N WAGGONER RD, BLACKLICK, OH 43004-8669
(614) 344-0419
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-416327
OH
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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