Individual
ANISA M MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
548 SE JACKSON ST, ROSEBURG, OR 97470-4983
(541) 530-6777
Mailing address
11 BRINLEY ST APT 2, NEWPORT, RI 02840-3238
(401) 207-6974
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/23/2019
Last updated
06/22/2022
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