Individual
MACKENZIE PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1156 OLD STATE ROAD 46, NASHVILLE, IN 47448-9211
(812) 988-2258
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009859A
IN
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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