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Individual

MACKENZIE MARIE PELKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
2520 12TH AVE E, NORTH ST PAUL, MN 55109-2420
(651) 748-7450
Mailing address
2520 12TH AVE E, NORTH ST PAUL, MN 55109-2420
(651) 748-7450

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1024870
MN
235Z00000X
Speech-Language Pathologist
Primary
5234
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5234-154
WI DEPARTMENT OF SAFETY & PROFESSIONAL SERVICES
WI
Enumeration date
06/28/2021
Last updated
04/17/2026
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