Provider Demographics
NPI:1699300913
Name:MACKEY, MICHELLE N (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:N
Last Name:MACKEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 HIGHCREST DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5923
Mailing Address - Country:US
Mailing Address - Phone:682-225-7566
Mailing Address - Fax:
Practice Address - Street 1:932 HIGHCREST DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5923
Practice Address - Country:US
Practice Address - Phone:817-472-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171W00000XOther Service ProvidersContractor