Doctor Name: | DR. NANCY MACKAY |
NPI Number: | 1134183569 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | PY0004573 |
Business Practice Address: | 1970 Michigan Ave Suite J-2 Cocoa, FL - 329225758 |
Business Phone Number: | 3216394483 |
Business Fax Number: | 3216900848 |
Mailing Address: | 1970 Michigan Ave, Suite J-2 COCOA |
State: | FL |
Postal Code: | 329225758 |
Phone Number: | 3216394483 |
Fax Number: | 3216900848 |
NPI Enumeration Date: | 04/13/2006 |
NPI Last Update Date: | 08/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY0004573 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |