Provider Demographics
NPI:1174045595
Name:GIDMAN, BETH ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:GIDMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 MALL RD STE F
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:MO
Mailing Address - Zip Code:65672-9603
Mailing Address - Country:US
Mailing Address - Phone:417-339-0007
Mailing Address - Fax:
Practice Address - Street 1:180 MALL RD STE F
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:MO
Practice Address - Zip Code:65672-9603
Practice Address - Country:US
Practice Address - Phone:417-339-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist