Individual
KAYLA A MACKEDANZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
(763) 746-9492
Mailing address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/21/2024
Last updated
11/21/2024
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