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General NPI Number Information
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NPI Number | 1164236329
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Entity Type | Individual
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Provider Name | MCKENZIE WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 4124 WATERMELON RD STE B
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City | NORTHPORT
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State | AL
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Zip | 35473-5252
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Country | US
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Telephone | 574-612-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 3RD CT APT 602
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City | TUSCALOOSA
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State | AL
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Zip | 35401-5076
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Country | US
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Telephone | 574-612-1797
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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