| NPI | 1578136800 |
|---|---|
| Former Name | MCKENZIE MELLOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C10061) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R7661) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2026-07-24 |