Healthcare Provider Details

I. General information

NPI: 1447721568
Provider Name (Legal Business Name): MCKENZIE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MCKENZIE PIPER

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6211 TAYLOR DR
FLINT MI
48507-4665
US

IV. Provider business mailing address

525 OKEMOS ST
MASON MI
48854-1224
US

V. Phone/Fax

Practice location:
  • Phone: 810-237-0799
  • Fax: 517-676-5460
Mailing address:
  • Phone: 517-833-8100
  • Fax: 517-676-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: