Provider Demographics
NPI:1306376330
Name:TECHO, MCKENZIE GRACE (SLP)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:GRACE
Last Name:TECHO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:GRACE
Other - Last Name:TESCHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:11660 ALPHARETTA HWY STE 320
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3878
Mailing Address - Country:US
Mailing Address - Phone:770-754-9288
Mailing Address - Fax:770-754-9288
Practice Address - Street 1:11660 ALPHARETTA HWY STE 320
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3878
Practice Address - Country:US
Practice Address - Phone:770-754-9288
Practice Address - Fax:770-754-9288
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP009723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist