Provider Demographics
NPI:1437459575
Name:MCCALL, BETH A (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:A
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 HILLSDALE AVE # B
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-1148
Mailing Address - Country:US
Mailing Address - Phone:440-245-5054
Mailing Address - Fax:
Practice Address - Street 1:1315 HILLSDALE AVE # B
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-1148
Practice Address - Country:US
Practice Address - Phone:440-245-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-9825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist