Provider Demographics
NPI:1275241531
Name:BEELS, MAKENZIE M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAKENZIE
Middle Name:M
Last Name:BEELS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MAKENZIE
Other - Middle Name:M
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1000 W. STATE ST.
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:PA
Mailing Address - Zip Code:16232
Mailing Address - Country:US
Mailing Address - Phone:814-657-0815
Mailing Address - Fax:814-226-1240
Practice Address - Street 1:499 MAYFIELD RD
Practice Address - Street 2:OFFICE 134
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214
Practice Address - Country:US
Practice Address - Phone:814-226-1355
Practice Address - Fax:814-226-1240
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL016245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist