| NPI | 1356611768 |
|---|---|
| Other Name | MCKENZIE NICOLE MAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IA 089447) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 3629-154) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2018-07-13 |