Provider Demographics
NPI:1851506687
Name:GUINN, BETHOLYN ANN SR (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETHOLYN
Middle Name:ANN
Last Name:GUINN
Suffix:SR
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 S TELLURIDE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3115
Mailing Address - Country:US
Mailing Address - Phone:303-400-6616
Mailing Address - Fax:
Practice Address - Street 1:6141 S TELLURIDE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-3115
Practice Address - Country:US
Practice Address - Phone:303-400-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CO0340967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09109489OtherASHA
CO0340961OtherSPECIAL SERVICES PROVIDER