Provider Demographics
NPI:1417020421
Name:LANDRY-MURPHY, BETH M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:LANDRY-MURPHY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SPARTA DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1174
Mailing Address - Country:US
Mailing Address - Phone:720-244-2849
Mailing Address - Fax:
Practice Address - Street 1:1015 SPARTA DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1174
Practice Address - Country:US
Practice Address - Phone:720-244-2849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003543235Z00000X
NH1409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67158030Medicaid