Provider Demographics
NPI:1659054146
Name:DOERING, BETHANY LYNN
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:DOERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4175 SHAYLER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-2616
Mailing Address - Country:US
Mailing Address - Phone:513-709-4185
Mailing Address - Fax:
Practice Address - Street 1:1500 NAGEL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2544
Practice Address - Country:US
Practice Address - Phone:513-474-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20232442-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist