Individual
MCKENZIE BROTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
403 PHEASANT RIDGE DR, TAYLORS, SC 29687-1819
(386) 366-4951
Mailing address
403 PHEASANT RIDGE DR, TAYLORS, SC 29687-1819
(386) 366-4951
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7257
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14130126
ASHA CERTIFICATE OF CLINICAL COMPETENCE
—
Enumeration date
10/28/2021
Last updated
12/09/2022
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