Provider Demographics
NPI:1467606061
Name:FERENCE, BETHANY LEIGH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LEIGH
Last Name:FERENCE
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 1:46 IRVING RD
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-2423
Mailing Address - Country:US
Mailing Address - Phone:518-928-6230
Mailing Address - Fax:
Practice Address - Street 1:2841 THOUSAND ACRES RD
Practice Address - Street 2:
Practice Address - City:DELANSON
Practice Address - State:NY
Practice Address - Zip Code:12053-1917
Practice Address - Country:US
Practice Address - Phone:518-875-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015963-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist