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General NPI Number Information
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NPI Number | 1245364967
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Entity Type | Individual
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Provider Name | STEPHANIE MACKEY M.S.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 3825 E THOUSAND OAKS BLVD STE O
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-6637
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Country | US
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Telephone | 805-496-1674
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 STRANDWAY COURT
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-1731
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Country | US
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Telephone | 805-449-1004
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU2471
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License Number State | CA
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