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General NPI Number Information
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NPI Number | 1033089727
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Entity Type | Individual
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Provider Name | YMAHNE SIMONE MCKENZIE
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Gender | Female
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2644 RIVA RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7427
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Country | US
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Telephone | 410-555-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 279 RED CLAY RD APT 102
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City | LAUREL
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State | MD
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Zip | 20724-2326
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Country | US
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Telephone | 718-490-7858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 39074
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License Number State | MD
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