Provider Demographics
NPI:1073769295
Name:DUMAS, BETH ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:DUMAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 RUGAR ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-3121
Mailing Address - Country:US
Mailing Address - Phone:518-569-0679
Mailing Address - Fax:
Practice Address - Street 1:226 RUGAR ST APT 2
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3121
Practice Address - Country:US
Practice Address - Phone:518-569-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018078-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist