Provider Demographics
NPI:1326703075
Name:HOLDEN, MCKENZIE (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MCKENZIE
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:MISS
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-3969
Mailing Address - Country:US
Mailing Address - Phone:864-706-4383
Mailing Address - Fax:
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3449
Practice Address - Country:US
Practice Address - Phone:803-704-4759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist