Provider Demographics
NPI:1639873854
Name:HANDLON, MAKENZIE KAYLA
Entity Type:Individual
Prefix:MRS
First Name:MAKENZIE
Middle Name:KAYLA
Last Name:HANDLON
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 1:1341 CHARLOTTE WAY
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8748
Mailing Address - Country:US
Mailing Address - Phone:317-919-7699
Mailing Address - Fax:
Practice Address - Street 1:1176 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1251
Practice Address - Country:US
Practice Address - Phone:812-343-2797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist