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General NPI Number Information
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NPI Number | 1326904285
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Entity Type | Individual
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Provider Name | MACKENZIE GANSMANN
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Gender | Female
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 325 VIOLA WAY
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City | WASHOE VALLEY
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State | NV
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Zip | 89704-9591
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Country | US
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Telephone | 970-819-9729
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Fax |
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Provider Business Mailing Address
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Address Line | 7690 BASIN RUN CT
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City | RENO
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State | NV
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Zip | 89523-3812
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Country | US
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Telephone | 970-819-9729
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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