Provider Demographics
NPI:1942577408
Name:EDELSTEIN, BEATRICE DORA (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:DORA
Last Name:EDELSTEIN
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 AKOKI ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-8810
Mailing Address - Country:US
Mailing Address - Phone:808-652-5535
Mailing Address - Fax:
Practice Address - Street 1:2410 AKOKI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-8810
Practice Address - Country:US
Practice Address - Phone:808-652-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI533235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist