Provider Demographics
NPI:1396414264
Name:BEAM, DELANEY RENEE
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:RENEE
Last Name:BEAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 ANITA DR
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3800
Mailing Address - Country:US
Mailing Address - Phone:512-800-2538
Mailing Address - Fax:
Practice Address - Street 1:2702 ANITA DR
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3800
Practice Address - Country:US
Practice Address - Phone:512-800-2538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist