Individual
MACKENZIE ANN FEDOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10440 SHAKER DR STE 207, COLUMBIA, MD 21046-2339
(443) 328-4946
Mailing address
11510 OLD GEORGETOWN RD STE F, ROCKVILLE, MD 20852-2736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC17466
MD
101YM0800X
Mental Health Counselor
Primary
LGP14876
MD
Other
Enumeration date
02/28/2024
Last updated
03/10/2026
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