Provider Demographics
NPI:1821205972
Name:SATTOVIA, BETHANY LOUISE (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LOUISE
Last Name:SATTOVIA
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 ARDMORE CREEK DR APT 2
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5332
Mailing Address - Country:US
Mailing Address - Phone:636-536-6973
Mailing Address - Fax:
Practice Address - Street 1:550 WHITE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2316
Practice Address - Country:US
Practice Address - Phone:314-469-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006003283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist