Provider Demographics
NPI:1477871606
Name:BELLEVUE, BEVERLY W (MAT-CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:W
Last Name:BELLEVUE
Suffix:
Gender:F
Credentials:MAT-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LIAMS CT
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2168
Mailing Address - Country:US
Mailing Address - Phone:603-427-2453
Mailing Address - Fax:603-427-2453
Practice Address - Street 1:117 NORTH RD
Practice Address - Street 2:RCNH REHAB DEPARTMENT
Practice Address - City:BRENTWOOD
Practice Address - State:NH
Practice Address - Zip Code:03833-6624
Practice Address - Country:US
Practice Address - Phone:603-679-3114
Practice Address - Fax:603-679-3115
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist