Provider Demographics
NPI:1497148027
Name:MCCOY, BETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:MCCOY
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 1:610 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-4408
Mailing Address - Country:US
Mailing Address - Phone:802-362-7086
Mailing Address - Fax:
Practice Address - Street 1:610 WINTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-4408
Practice Address - Country:US
Practice Address - Phone:802-362-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT8001682235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist