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Individual

AIDZA Y. MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
108 RUSSELL ST, HADLEY, MA 01035-9595
(413) 387-0075
(413) 387-0074
Mailing address
108 RUSSELL ST, HADLEY, MA 01035-9595
(413) 387-0075
(413) 387-0074

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8152
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W10610
BLUE CROSS PROVIDER NUMBE
MA
Enumeration date
01/09/2007
Last updated
03/09/2009
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