Provider Demographics
NPI:1346397361
Name:BECKWITH-BROWN, ROSALIND L (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROSALIND
Middle Name:L
Last Name:BECKWITH-BROWN
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 1:8434 BERESFORD LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-7135
Mailing Address - Country:US
Mailing Address - Phone:904-534-7458
Mailing Address - Fax:
Practice Address - Street 1:3311 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3704
Practice Address - Country:US
Practice Address - Phone:904-396-1462
Practice Address - Fax:904-396-1199
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5999235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist