Provider Demographics
NPI:1609922996
Name:LANZI, BETH KRASNER (MA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:KRASNER
Last Name:LANZI
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 12TH ST
Mailing Address - Street 2:APT. C
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-5888
Mailing Address - Country:US
Mailing Address - Phone:707-825-8039
Mailing Address - Fax:707-825-8039
Practice Address - Street 1:825 12TH ST
Practice Address - Street 2:APT. C
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5888
Practice Address - Country:US
Practice Address - Phone:707-825-8039
Practice Address - Fax:707-825-8039
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP8497235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP8497OtherSTATE LICENSE