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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119814 | Other | VITALSTIM THERAPY PROVIDER | |
| 12095826 | Other | PA | AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION |
| SL009436 | Other | PA | PA STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS |
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All providers in Dover, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.