Provider Demographics
NPI:1831675933
Name:GOLZ, MCKENZIE (OTD, OTR/L, BCP)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:GOLZ
Suffix:
Gender:F
Credentials:OTD, OTR/L, BCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W CUSTER AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0106
Mailing Address - Country:US
Mailing Address - Phone:406-594-4383
Mailing Address - Fax:403-403-0588
Practice Address - Street 1:104 W CUSTER AVE STE 5
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0106
Practice Address - Country:US
Practice Address - Phone:907-345-0050
Practice Address - Fax:907-344-5103
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK133696225X00000X
MTOT-POC-LIC-8685225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist