Most Relevant Information
Provider Data
| NPI Number: | 1003215740 |
| Provider Name: | KEITH MCKENZIE CADC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 0656 |
Most Important Dates
| Enumeration Date: | 08/19/2014 |
| Last Updated: | 10/31/2017 |
Provider Practice Location
332 W BROADWAY STE 905
LOUISVILLE
KY
402022133
Practice Location Phone/Fax
| Phone: | 5025879737 |
| Fax: |
Provider Mailing Location
332 W BROADWAY STE 905
LOUISVILLE
KY
402022133
Provider Mailing Phone/Fax
| Phone: | 5025879737 |
| Fax: |