Provider Demographics
NPI:1619609260
Name:KLEIN, BETHANY G (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:G
Last Name:KLEIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9692 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76534-5603
Mailing Address - Country:US
Mailing Address - Phone:325-201-8314
Mailing Address - Fax:
Practice Address - Street 1:7349 HONEYSUCKLE STE 100
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5888
Practice Address - Country:US
Practice Address - Phone:254-780-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist