Provider Demographics
NPI:1073984936
Name:TOUTAIN, BEVERLY ANN (MS-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:TOUTAIN
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 1:300 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-4510
Mailing Address - Country:US
Mailing Address - Phone:740-397-7422
Mailing Address - Fax:740-393-5949
Practice Address - Street 1:300 NEWARK RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-4510
Practice Address - Country:US
Practice Address - Phone:740-397-7422
Practice Address - Fax:740-393-5949
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.9826235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist