Provider Demographics
NPI:1619139102
Name:KILLMEIER, BETH MILLER (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:MILLER
Last Name:KILLMEIER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 FAIRBANKS CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-9700
Mailing Address - Country:US
Mailing Address - Phone:910-347-6087
Mailing Address - Fax:
Practice Address - Street 1:1316 FAIRBANKS CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-9700
Practice Address - Country:US
Practice Address - Phone:910-347-6087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6372235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist