Provider Demographics
NPI:1518263425
Name:BEH, JENNIFER L (LMT,LET,LLCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BEH
Suffix:
Gender:F
Credentials:LMT,LET,LLCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7249 SE HOBE TER
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-6121
Mailing Address - Country:US
Mailing Address - Phone:561-379-6362
Mailing Address - Fax:
Practice Address - Street 1:7249 SE HOBE TER
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-6121
Practice Address - Country:US
Practice Address - Phone:561-379-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA26317225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist