Provider Demographics
NPI:1710127709
Name:BREIDING, BETH A (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:BREIDING
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 1:154 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2765
Mailing Address - Country:US
Mailing Address - Phone:304-280-7461
Mailing Address - Fax:
Practice Address - Street 1:154 STONEGATE DR
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2765
Practice Address - Country:US
Practice Address - Phone:304-280-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist