Provider Demographics
NPI:1427932821
Name:MCKEEVER, MARIAH L
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:L
Last Name:MCKEEVER
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 1:5601 33RD AVE S APT 213
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-0004
Mailing Address - Country:US
Mailing Address - Phone:218-280-4543
Mailing Address - Fax:
Practice Address - Street 1:4575 23RD AVE S STE 400
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8783
Practice Address - Country:US
Practice Address - Phone:701-347-1782
Practice Address - Fax:701-404-8274
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist