Beth Agres

Individual provider Active NPI Speech-Language Pathologist · Pocatello, ID

NPI 1013367580 · NPPES record last updated Dec 22, 2023

Key facts

NPI
1013367580
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1001 N 7TH Ave
Pocatello, ID 83201-5761
Phone
(208) 239-1490
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Hospital LLC Past Accepting new patients
PHS Ambulatory Services LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

1001 N 7TH Ave
Pocatello, ID 83201-5761

Mailing address

9842 W Bighorn Dr
Pocatello, ID 83204-7222
Phone (757) 376-0167

Other providers in Pocatello, ID

All providers in Pocatello, ID · Speech-Language Pathologist in Idaho

Sources for this page

Verify at the official NPI Registry.