Provider Demographics
NPI:1558813337
Name:ALT, BETH A (MA)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:ALT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2606
Mailing Address - Country:US
Mailing Address - Phone:513-619-2381
Mailing Address - Fax:
Practice Address - Street 1:825 LAKERIDGE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2606
Practice Address - Country:US
Practice Address - Phone:513-619-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-5914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist