Healthcare Provider Details

I. General information

NPI: 1275241531
Provider Name (Legal Business Name): MAKENZIE M BEELS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAKENZIE M MAY SLP

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 MAYFIELD RD OFFICE 134
CLARION PA
16214
US

IV. Provider business mailing address

1000 W. STATE ST.
KNOX PA
16232
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-1355
  • Fax: 814-226-1240
Mailing address:
  • Phone: 814-657-0815
  • Fax: 814-226-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL016245
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: