Provider Demographics
NPI:1851605042
Name:BESWICK, CAROL J
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:BESWICK
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:PO BOX 90915
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20090-0915
Mailing Address - Country:US
Mailing Address - Phone:202-255-5517
Mailing Address - Fax:202-299-0590
Practice Address - Street 1:1826 KENYON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2619
Practice Address - Country:US
Practice Address - Phone:202-255-5517
Practice Address - Fax:202-299-0590
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12061620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist