Healthcare Provider Details

I. General information

NPI: 1043157316
Provider Name (Legal Business Name): MACKENZIE E HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24871 S ELLSWORTH RD STE 100-150
QUEEN CREEK AZ
85142-1574
US

IV. Provider business mailing address

511 W HOLSTEIN TRL
SAN TAN VALLEY AZ
85143-5481
US

V. Phone/Fax

Practice location:
  • Phone: 480-999-7779
  • Fax: 480-359-4033
Mailing address:
  • Phone: 909-917-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number24-6586-675882
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: