Healthcare Provider Details

I. General information

NPI: 1174292700
Provider Name (Legal Business Name): MACKENSEY GEBERS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6924 SPRING VALLEY DR
HOLLAND OH
43528-9488
US

IV. Provider business mailing address

1432 TAYLOR DR
NAPOLEON OH
43545-1141
US

V. Phone/Fax

Practice location:
  • Phone: 419-867-5600
  • Fax: 419-867-5700
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT011299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: