Provider Demographics
NPI:1679311849
Name:MCKENZIE, RAYNE LYRIC (SLPA)
Entity type:Individual
Prefix:
First Name:RAYNE
Middle Name:LYRIC
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 W STOCKTON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8070
Mailing Address - Country:US
Mailing Address - Phone:916-230-3647
Mailing Address - Fax:
Practice Address - Street 1:9300 W STOCKTON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8070
Practice Address - Country:US
Practice Address - Phone:916-230-3647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant