Provider Demographics
NPI:1518457811
Name:SAARI, MYCKENZIE
Entity Type:Individual
Prefix:
First Name:MYCKENZIE
Middle Name:
Last Name:SAARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 DOLAN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-9313
Mailing Address - Country:US
Mailing Address - Phone:701-330-9168
Mailing Address - Fax:
Practice Address - Street 1:159 DOLAN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ND
Practice Address - Zip Code:58504-9313
Practice Address - Country:US
Practice Address - Phone:701-202-4035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist