Individual
JELLY MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
295 E WILLIAMS AVE, FALLON, NV 89406-3020
(775) 867-5615
Mailing address
1825 CHELCIE ST, FALLON, NV 89406-8263
(775) 423-0197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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