Provider Demographics
NPI:1437969177
Name:MEYER, BETH RENEE
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:RENEE
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 N YUKON AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57107-2150
Mailing Address - Country:US
Mailing Address - Phone:712-371-3177
Mailing Address - Fax:
Practice Address - Street 1:47260 258TH ST
Practice Address - Street 2:
Practice Address - City:RENNER
Practice Address - State:SD
Practice Address - Zip Code:57055-6517
Practice Address - Country:US
Practice Address - Phone:605-543-5273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1353-PROV235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist