Healthcare Provider Details

I. General information

NPI: 1992551246
Provider Name (Legal Business Name): MCKENZIE JAELYNN MERCER M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 N. 44TH STREET
PHOENIX AZ
85018
US

IV. Provider business mailing address

3303 N. 44TH STREET
PHOENIX AZ
85018
US

V. Phone/Fax

Practice location:
  • Phone: 480-478-0444
  • Fax: 602-854-7422
Mailing address:
  • Phone: 480-478-0444
  • Fax: 602-854-7422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP15847
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: