| NPI | 1548089659 |
|---|---|
| Former Name | MACKENZIE ANN BUSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 29372) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149022275) |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-09 |