Provider Demographics
NPI:1215395157
Name:KLEIN, MCKENZIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 RED BIRD LN
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2401
Mailing Address - Country:US
Mailing Address - Phone:910-616-6575
Mailing Address - Fax:
Practice Address - Street 1:18676 US HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-4049
Practice Address - Country:US
Practice Address - Phone:910-821-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-07
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10157225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics