Individual
MCKENZIE BRAZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
2221 DILLON RD, CLOVIS, NM 88101-9454
(575) 762-4495
Mailing address
2221 DILLON RD, CLOVIS, NM 88101-9454
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
104948
TX
235Z00000X
Speech-Language Pathologist
5491
NM
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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