Provider Demographics
NPI:1265039614
Name:MCKENZIE, BERNICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1275
Mailing Address - Street 2:
Mailing Address - City:SOUTH LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01561-1275
Mailing Address - Country:US
Mailing Address - Phone:347-938-0889
Mailing Address - Fax:
Practice Address - Street 1:4 SODOM RD
Practice Address - Street 2:
Practice Address - City:NORTH FRANKLIN
Practice Address - State:CT
Practice Address - Zip Code:06254-1821
Practice Address - Country:US
Practice Address - Phone:347-938-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker