Provider Demographics
NPI:1467612457
Name:AMES, MARYBETH (SLPD, CCC/L)
Entity Type:Individual
Prefix:DR
First Name:MARYBETH
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:SLPD, CCC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 GOODLETTE RD N
Mailing Address - Street 2:STE #150
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5458
Mailing Address - Country:US
Mailing Address - Phone:239-434-9512
Mailing Address - Fax:239-643-5908
Practice Address - Street 1:681 GOODLETTE RD N
Practice Address - Street 2:STE #150
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5458
Practice Address - Country:US
Practice Address - Phone:239-434-9512
Practice Address - Fax:239-643-5908
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9139235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist