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General NPI Number Information
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NPI Number | 1669153086
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Entity Type | Individual
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Provider Name | MACKENZIE LEIGHTY MT-BC
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 6006 BARTON RD
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City | MADISON
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State | WI
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Zip | 53711-3301
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Country | US
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Telephone | 828-564-3333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | MARION
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State | IA
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Zip | 52302-0986
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Country | US
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Telephone |
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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