Individual provider · Type 1 NPI

Mackenzie Wise

Mental Health Counselor · Beavercreek, OH

NPI number 1407617467 Active

Practice location

3171 Beaver Vu Dr Ste C
Beavercreek, OH 45434-6368

Call (937) 306-8077 Map

Fax (937) 306-8079

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XC.2405463-TRNE (OH)
Counselor 101Y00000XC.2405463-TRNE (OH)

Mental Health Counselor: Definition to come...

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About NPI 1407617467

Mackenzie Wise's National Provider Identifier is 1407617467, issued on Jan 17, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Beavercreek, OH. The record was last updated on Jan 17, 2024.