Provider Demographics
NPI:1679735484
Name:WHALEN, BEVERLY JEAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:JEAN
Last Name:WHALEN
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 1:7 SUNFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-8221
Mailing Address - Country:US
Mailing Address - Phone:845-223-6481
Mailing Address - Fax:
Practice Address - Street 1:1938 ROUTE 6
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2311
Practice Address - Country:US
Practice Address - Phone:845-225-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007301-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist