Provider Demographics
NPI:1922361443
Name:FROEHLICH COLLINS, BETHANY MARIE (MS)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIE
Last Name:FROEHLICH COLLINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S 5TH ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-2614
Mailing Address - Country:US
Mailing Address - Phone:406-493-4487
Mailing Address - Fax:
Practice Address - Street 1:700 S 5TH ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-2614
Practice Address - Country:US
Practice Address - Phone:406-493-4487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0005944235Z00000X
MTSLP-SP-TMP-2253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist