Provider Demographics
NPI:1689104036
Name:SANDERS, BETH A
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:SANDERS
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 1:4535 SOUTHWESTERN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1861
Mailing Address - Country:US
Mailing Address - Phone:716-202-1161
Mailing Address - Fax:716-202-4423
Practice Address - Street 1:4535 SOUTHWESTERN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1861
Practice Address - Country:US
Practice Address - Phone:716-202-1161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant