Provider Demographics
NPI:1689329583
Name:ARMSTRONG, MACKENZIE NOEL (OTR/L)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:NOEL
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 COZY CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-6049
Mailing Address - Country:US
Mailing Address - Phone:636-345-1424
Mailing Address - Fax:
Practice Address - Street 1:500 KIME ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:MO
Practice Address - Zip Code:65781-7265
Practice Address - Country:US
Practice Address - Phone:417-742-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022023758225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist