Provider Demographics
NPI:1659894947
Name:PEED, MACKENZIE JUNE
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:JUNE
Last Name:PEED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2828
Mailing Address - Country:US
Mailing Address - Phone:609-980-3738
Mailing Address - Fax:
Practice Address - Street 1:7 ASTER CT
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075
Practice Address - Country:US
Practice Address - Phone:609-980-3738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer