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
Phone: (410) 973-2301
Fax: (410) 973-2305
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619496502 | NPPES |
| Maryland | MEDICAID | 483106300 |
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