Provider Demographics
NPI:1972309862
Name:KALEY, MADISON (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:KALEY
Suffix:
Gender:
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:ADEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12616 352ND ST
Mailing Address - Street 2:
Mailing Address - City:LINDSTROM
Mailing Address - State:MN
Mailing Address - Zip Code:55045-6900
Mailing Address - Country:US
Mailing Address - Phone:507-254-3573
Mailing Address - Fax:
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-520-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist