Provider Demographics
NPI:1962635003
Name:KIRCH, BETH ANN
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:KIRCH
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 1:14 BRANCHWOOD DR
Mailing Address - Street 2:SILVER VIEW FARM
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-1002
Mailing Address - Country:US
Mailing Address - Phone:302-228-9337
Mailing Address - Fax:
Practice Address - Street 1:14 BRANCHWOOD DR
Practice Address - Street 2:SILVER VIEW FARM
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-1002
Practice Address - Country:US
Practice Address - Phone:302-228-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant