Provider Demographics
NPI:1457860892
Name:BIESINGER, MEKENA RENEE
Entity Type:Individual
Prefix:MRS
First Name:MEKENA
Middle Name:RENEE
Last Name:BIESINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEKENA
Other - Middle Name:RENEE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 BEVILLE RD APT 113
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5779
Mailing Address - Country:US
Mailing Address - Phone:719-593-9321
Mailing Address - Fax:
Practice Address - Street 1:1128 BEVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5747
Practice Address - Country:US
Practice Address - Phone:386-267-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician