Provider Demographics
NPI:1598964710
Name:BEAUCHAMP, AMY RUTH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:RUTH
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15180 OLD HICKORY BLVD
Mailing Address - Street 2:UNIT 713
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6503
Mailing Address - Country:US
Mailing Address - Phone:615-934-3584
Mailing Address - Fax:
Practice Address - Street 1:103 ARCARO PL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5061
Practice Address - Country:US
Practice Address - Phone:615-934-3584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5967861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist