Provider Demographics
NPI:1770322596
Name:HIGHBARGER, MAKENZIE GRACE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:GRACE
Last Name:HIGHBARGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 THORNDALE PL
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1111
Mailing Address - Country:US
Mailing Address - Phone:240-818-3327
Mailing Address - Fax:
Practice Address - Street 1:901 E 8TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1354
Practice Address - Country:US
Practice Address - Phone:484-842-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL017343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist