McKenzie Shae Birchler

Individual provider Active NPI Developmental Therapist · Owensboro, KY

NPI 1235913757 · NPPES record last updated Jan 29, 2024

Key facts

NPI
1235913757
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
201181711 (KY)
Practice address
6636 Autumn CRK
Owensboro, KY 42301-8046
Phone
(270) 313-2848
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
201181711KYMDDevelopmental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X KY
Developmental Therapist 222Q00000X 201181711 KY Yes

Addresses

Primary practice location

6636 Autumn CRK
Owensboro, KY 42301-8046

Mailing address

6636 Autumn CRK
Owensboro, KY 42301-8046
Phone (270) 313-2848

Other providers in Owensboro, KY

All providers in Owensboro, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.