Provider Demographics
NPI:1710325600
Name:KLINE, MAKENZIE (AUD)
Entity Type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 EASTERN BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-1962
Mailing Address - Country:US
Mailing Address - Phone:812-283-4327
Mailing Address - Fax:812-283-5466
Practice Address - Street 1:914 EASTERN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1962
Practice Address - Country:US
Practice Address - Phone:812-283-4327
Practice Address - Fax:812-283-5466
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0570231H00000X
IN23002568A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist