| NPI | 1629804471 |
|---|---|
| Former Name | MACKENZI GOTCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 8072) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 14048) |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-20 |