Provider Demographics
NPI:1952999435
Name:SPRINGFORD, MCKENZIE MAY
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:MAY
Last Name:SPRINGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9048 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:APPLE CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44606-9408
Mailing Address - Country:US
Mailing Address - Phone:330-698-3001
Mailing Address - Fax:
Practice Address - Street 1:9048 DOVER RD
Practice Address - Street 2:
Practice Address - City:APPLE CREEK
Practice Address - State:OH
Practice Address - Zip Code:44606-9408
Practice Address - Country:US
Practice Address - Phone:330-698-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20201605-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist