Provider Demographics
NPI:1801816012
Name:BETHEA, YVETTE V (MS, CCC/A)
Entity Type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:V
Last Name:BETHEA
Suffix:
Gender:F
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10713 N OAK HILLS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2967
Mailing Address - Country:US
Mailing Address - Phone:225-389-6375
Mailing Address - Fax:225-372-8619
Practice Address - Street 1:10713 N OAK HILLS PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2967
Practice Address - Country:US
Practice Address - Phone:225-389-6375
Practice Address - Fax:225-372-8619
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2758231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist