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NPI Code Detail

MEDICARE: MACKENZIE REYNOLDS

MEDICARE: MACKENZIE REYNOLDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1528909116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE REYNOLDS
Provider Business Mailing Address
First Line : 10475 CROSSPOINT BLVD STE 250
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3387
Country : US
Telephone Number : 462-205-0087
Fax Number : 462-205-0087
Provider Business Practice Location Address
First Line : 10475 CROSSPOINT BLVD STE 250
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3387
Country : US
Telephone Number : 462-205-0087
Fax Number : 462-205-0087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ MACKENZIE REYNOLDS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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