Healthcare Provider Details

I. General information

NPI: 1114707387
Provider Name (Legal Business Name): MACKENZIE CORTEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 AIRMOTIVE WAY STE 200
RENO NV
89502-3240
US

IV. Provider business mailing address

355 E PLUMB LN # 1013
RENO NV
89502-3405
US

V. Phone/Fax

Practice location:
  • Phone: 775-224-5132
  • Fax:
Mailing address:
  • Phone: 775-235-6624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: