Beth Michele Hefenieder, MS, SLP-CCC

Individual provider Active NPI Speech-Language Pathologist · Basin, WY

NPI 1609601467 · NPPES record last updated Sep 3, 2024

Key facts

NPI
1609601467
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP-1113 (WY)
Practice address
115 S 4TH St
Basin, WY 82410-5012
Phone
(307) 568-2914
NPI assigned
Sep 3, 2024
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)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP-1113WYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-1113 WY Yes

Addresses

Primary practice location

115 S 4TH St
Basin, WY 82410-5012

Mailing address

PO Box 973
Worland, WY 82401-0973

Other providers in Basin, WY

All providers in Basin, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.