Provider Demographics
NPI:1033325998
Name:BEY, GRETEL LYS (MA)
Entity Type:Individual
Prefix:
First Name:GRETEL
Middle Name:LYS
Last Name:BEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 DONOVAN CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-4769
Mailing Address - Country:US
Mailing Address - Phone:303-682-2645
Mailing Address - Fax:
Practice Address - Street 1:163 DONOVAN CT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4769
Practice Address - Country:US
Practice Address - Phone:303-682-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist