Provider Demographics
NPI:1306827084
Name:COLSON, BETHANY GEHRLEIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:GEHRLEIN
Last Name:COLSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:LYN
Other - Last Name:GEHRLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11378 CHERRY BLOSSOM WEST DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2414
Mailing Address - Country:US
Mailing Address - Phone:317-828-7202
Mailing Address - Fax:317-471-8627
Practice Address - Street 1:9192 WALDEMAR RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1131
Practice Address - Country:US
Practice Address - Phone:317-471-8560
Practice Address - Fax:317-471-8627
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004321A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist