Provider Demographics
NPI:1972278893
Name:MCKENZIE SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:MCKENZIE SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:406-530-7188
Mailing Address - Street 1:6068 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9685
Mailing Address - Country:US
Mailing Address - Phone:406-530-7188
Mailing Address - Fax:844-415-2186
Practice Address - Street 1:6068 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-9685
Practice Address - Country:US
Practice Address - Phone:406-530-7188
Practice Address - Fax:844-415-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty