Provider Demographics
NPI:1770037418
Name:MCKENZIE, NOPI
Entity Type:Individual
Prefix:MRS
First Name:NOPI
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NOPI
Other - Middle Name:
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEDCCC-SLP
Mailing Address - Street 1:12017 FLOWER WOOD DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8106
Mailing Address - Country:US
Mailing Address - Phone:405-808-3907
Mailing Address - Fax:405-242-3961
Practice Address - Street 1:12017 FLOWER WOOD DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8106
Practice Address - Country:US
Practice Address - Phone:405-808-3907
Practice Address - Fax:405-242-3961
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist