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General NPI Number Information
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NPI Number | 1679439848
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Entity Type | Individual
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Provider Name | MACKENZIE BURKHOLDER
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Gender | Female
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 1900 E 15TH ST STE 800B
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City | EDMOND
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State | OK
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Zip | 73013-6682
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Country | US
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Telephone | 405-455-6868
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Fax | 405-562-3444
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Provider Business Mailing Address
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Address Line | 11575 BLUE HERON CRK
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City | GUTHRIE
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State | OK
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Zip | 73044-9117
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Country | US
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Telephone | 405-657-0444
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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 | 224ZR0403X
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Taxonomy Name | Driving and Community Mobility Occupational Therapy Assistant
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License Number |
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License Number State |
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