Provider Demographics
NPI:1942517180
Name:GABAVICS, BETH J (AUD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:J
Last Name:GABAVICS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-4292
Mailing Address - Country:US
Mailing Address - Phone:715-735-3187
Mailing Address - Fax:715-735-7072
Practice Address - Street 1:3200 SHORE DR
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-4292
Practice Address - Country:US
Practice Address - Phone:715-735-3187
Practice Address - Fax:715-735-7072
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI540-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist