MEDICARE: MACKENZIE MUHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MFTC.0014701	CO

General Provider Information

NPI Number	:	1346064110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE MUHA

Provider Business Mailing Address
First Line	:	PO BOX 1
Second Line	:
City	:	WINTER PARK
State	:	CO
Zip	:	80482-0001
Country	:	US
Telephone Number	:	815-508-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 1
Second Line	:
City	:	WINTER PARK
State	:	CO
Zip	:	80482-0001
Country	:	US
Telephone Number	:	815-508-2161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2024
Last Update Date	:	11/08/2024

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Directions to “ MACKENZIE MUHA ” Practice Location

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