Provider Demographics
NPI:1467282442
Name:BAXMANN, MACKENZIE SUZANNE (RBT)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:SUZANNE
Last Name:BAXMANN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16707 LIBSON FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5469
Mailing Address - Country:US
Mailing Address - Phone:713-384-9376
Mailing Address - Fax:
Practice Address - Street 1:16707 LIBSON FALLS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5469
Practice Address - Country:US
Practice Address - Phone:713-384-9376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-338206106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician