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General NPI Number Information
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NPI Number | 1235042524
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Entity Type | Individual
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Provider Name | MACKENZIE ROSE MURRAY
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Gender | Female
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Dates
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Enumeration Date | 09/26/2026
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Last Update Date | 09/26/2026
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Provider Practice Location Address
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Address Line | 1115 W CHESTNUT ST
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City | BROCKTON
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State | MA
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Zip | 02301-7501
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Country | US
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Telephone | 617-207-7712
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Fax |
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Provider Business Mailing Address
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Address Line | 64 MAIN ST
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City | LAKEVILLE
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State | MA
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Zip | 02347-1608
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Country | US
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Telephone | 774-992-2782
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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