Provider Demographics
NPI:1437804804
Name:CHAVEZ, BETHANY EPPLING (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:EPPLING
Last Name:CHAVEZ
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 1:13855 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-6220
Mailing Address - Country:US
Mailing Address - Phone:985-785-6289
Mailing Address - Fax:
Practice Address - Street 1:130 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3015
Practice Address - Country:US
Practice Address - Phone:985-725-0123
Practice Address - Fax:985-725-0131
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist