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General NPI Number Information
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NPI Number | 1669541991
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Entity Type | Individual
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Provider Name | KAY Q. MCKENZIE MD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 1611 SO GREEN RD SUITE 302
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City | CLEVELAND
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State | OH
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Zip | 44121-4192
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Country | US
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Telephone | 216-691-9420
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Fax | 216-297-3161
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Provider Business Mailing Address
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Address Line | 1611 SO GREEN RD SUITE 302
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City | CLEVELAND
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State | OH
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Zip | 44121-4192
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Country | US
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Telephone | 216-691-9420
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Fax | 216-297-3161
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35038548
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License Number State | OH
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