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General NPI Number Information
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NPI Number | 1861330722
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Entity Type | Individual
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Provider Name | MACKENZIE ELLIOTT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 152 E SCHOOL ST
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City | KING
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State | NC
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Zip | 27021-7954
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Country | US
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Telephone | 336-983-5824
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Fax |
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Provider Business Mailing Address
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Address Line | 100 COURTHOUSE CIR
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City | DANBURY
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State | NC
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Zip | 27016-7600
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Country | US
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Telephone | 336-536-9010
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 30004306
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License Number State | NC
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