Mckinzie, Shante

Mckinzie, Shante is an sole proprietor health care provider with primary practice located at 10514 Racetrack Rd Ste G , Berlin MD 21811-3241. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Mckinzie, Shante can be contacted via phone (410) 973-2301.

Contact Information

Primary practice address
10514 Racetrack Rd Ste G Berlin MD 21811-3241
Fax: (410) 973-2305
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X Maryland

Profile Details

NPI number 1619496502
LBN Legal business name Mckinzie, Shante
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2017
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619496502 NPPES
Maryland MEDICAID 483106300

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