Provider Demographics
NPI:1962644567
Name:BEILE, ROBERTA M (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:M
Last Name:BEILE
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12706 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2271
Mailing Address - Country:US
Mailing Address - Phone:913-897-6554
Mailing Address - Fax:
Practice Address - Street 1:510 E GAY ST STE E
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3107
Practice Address - Country:US
Practice Address - Phone:660-747-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009005681237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter