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General NPI Number Information
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NPI Number | 1346064110
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Entity Type | Individual
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Provider Name | MACKENZIE MUHA
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Gender | Female
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | PO BOX 1
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City | WINTER PARK
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State | CO
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Zip | 80482-0001
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Country | US
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Telephone | 815-508-2161
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | WINTER PARK
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State | CO
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Zip | 80482-0001
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Country | US
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Telephone | 815-508-2161
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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 | MFTC.0014701
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License Number State | CO
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