Provider Demographics
NPI:1174874069
Name:SCOTT, BETHANY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 SIMMONS ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6503
Mailing Address - Country:US
Mailing Address - Phone:415-763-5890
Mailing Address - Fax:
Practice Address - Street 1:2015 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6503
Practice Address - Country:US
Practice Address - Phone:415-763-5890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1471235Z00000X
KS3858235Z00000X
MESP2460235Z00000X
MD07597235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist