Individual
MACKENZIE ALLYN GOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1600 UNIVERSITY AVE W STE 203, SAINT PAUL, MN 55104-3838
(651) 645-0980
Mailing address
PO BOX 233, BLUE RIVER, OR 97413-0233
(541) 852-0899
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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