Bethany Guevara, M.S. CCC/SLP

Individual provider Active NPI Speech-Language Pathologist · Dover, PA

NPI 1104066349 · NPPES record last updated Nov 22, 2014

Key facts

NPI
1104066349
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL009436 (PA)
Practice address
3377 Fox Run Rd
Dover, PA 17315-3705
Phone
(717) 767-5634
Fax
(717) 767-5657
NPI assigned
Feb 28, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL009436 PA Yes

Addresses

Primary practice location

3377 Fox Run Rd
Dover, PA 17315-3705

Mailing address

3377 Fox Run Rd
Dover, PA 17315-3705
Phone (717) 767-5634

Other identifiers

IdentifierTypeStateIssuer
119814OtherVITALSTIM THERAPY PROVIDER
12095826OtherPAAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
SL009436OtherPAPA STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS

Other providers in Dover, PA

All providers in Dover, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.