Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Ryan Willis

Individual provider Pediatric Occupational Therapist · NPI 1821918699

Mackenzie Ryan Willis is a Pediatric Occupational Therapist in Old Bridge, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2026

Practice location Address checks out

87 Park Ave
Old Bridge, NJ 08857-1223
Phone: (732) 763-9467
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 46TR01295200 (NJ)

Record details

NPI number1821918699
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 20, 2026
Last updated in NPPESJuly 20, 2026
Certification dateJuly 20, 2026
Mailing address87 Park Ave, Old Bridge, NJ 08857-1223