Healthcare Provider Details

I. General information

NPI: 1508361460
Provider Name (Legal Business Name): MACKENZIE SUZANNE HAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MACKENZIE S WOCKENFUS OTR/L

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 STATE HIGHWAY 66
STEVENS POINT WI
54482-8410
US

IV. Provider business mailing address

4100 STATE HIGHWAY 66
STEVENS POINT WI
54482-8410
US

V. Phone/Fax

Practice location:
  • Phone: 715-343-7700
  • Fax:
Mailing address:
  • Phone: 715-343-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7205
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: