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NPI Code Detail

MEDICARE: MEKENZIE GAREY M.ED, BCBA

MEDICARE: MEKENZIE GAREY M.ED, BCBA
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
1103K00000XBehavior Analyst12369864OH

General Provider Information

NPI Number : 1568239838
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEKENZIE GAREY M.ED, BCBA
Provider Business Mailing Address
First Line : 1346 IROQUOIS AVE
Second Line :
City : AKRON
State : OH
Zip : 44312-4506
Country : US
Telephone Number : 330-906-2303
Fax Number :
Provider Business Practice Location Address
First Line : 150 N MILLER RD
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-3770
Country : US
Telephone Number : 330-867-2240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2023
Last Update Date : 05/19/2026

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