| NPI | 1992315147 |
|---|---|
| Former Name | MACKENZIE LUNA BAXLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 226828) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2024-03-27 |