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NPI Code Detail

MEDICARE: CASSANDRA MCKENZIE

MEDICARE: CASSANDRA MCKENZIE
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 Analyst

General Provider Information

NPI Number : 1689051914
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA MCKENZIE
Provider Business Mailing Address
First Line : 2700 E SUNSET RD STE 24
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3519
Country : US
Telephone Number : 702-499-7502
Fax Number :
Provider Business Practice Location Address
First Line : 2700 E SUNSET RD STE 24
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3519
Country : US
Telephone Number : 702-499-7502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2015
Last Update Date : 05/06/2015

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Directions to “ CASSANDRA MCKENZIE ” Practice Location

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