| NPI | 1679942742 |
|---|---|
| Former Name | MACKENZIE ALEXANDRA HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MT4388) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2024-02-08 |