MRS. Mckenzie Nicole Herndon, BSW

NPI #1063906741 in Valdosta, Georgia

Provider Information

NPI Number: 1063906741
Entity Type: Individual
Name: MRS. Mckenzie Nicole Herndon, BSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: BSW
Enumeration Date: Jun 18, 2018
Last Updated: Jun 18, 2018

Practice Location

Address: 4141 OLD IVY TRCE
City: Valdosta
State: Georgia
ZIP Code: 31605-5718
Phone: (229) 561-3920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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