Mackenzie J. Brown

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Moroni, UT

NPI 1386928901 · NPPES record last updated Sep 30, 2011

Key facts

NPI
1386928901
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
21260 North 1450 East
Moroni, UT 84646-0383
Phone
(435) 851-6281
NPI assigned
Sep 30, 2011
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

21260 North 1450 East
Moroni, UT 84646-0383

Mailing address

21260 North 1450 East
Moroni, UT 84646-0383

Other providers in Moroni, UT

All providers in Moroni, UT · Addiction (Substance Use Disorder) Counselor in Utah

Sources for this page

Verify at the official NPI Registry.