Provider Demographics
NPI:1518687441
Name:KITE, MACKENZIE RENEE
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:RENEE
Last Name:KITE
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 1:600 S CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FERRIS
Mailing Address - State:TX
Mailing Address - Zip Code:75125-3018
Mailing Address - Country:US
Mailing Address - Phone:972-544-3212
Mailing Address - Fax:
Practice Address - Street 1:600 S CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FERRIS
Practice Address - State:TX
Practice Address - Zip Code:75125-3018
Practice Address - Country:US
Practice Address - Phone:972-544-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist