Individual
MACKENZIE MAE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CLT
Contact information
Practice address
1200 1ST AVE E, SPENCER, IA 51301-4342
(712) 264-6593
Mailing address
72233 460TH AVE, LAKEFIELD, MN 56150-3345
(712) 264-5693
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01703
IA
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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