Provider Demographics
NPI:1295497139
Name:BEIKMAN, AUDREY RANDALL (CSLA)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:RANDALL
Last Name:BEIKMAN
Suffix:
Gender:F
Credentials:CSLA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2603
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:603-524-1497
Practice Address - Street 1:23 ONEIDA ST UNIT 1
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:NH
Practice Address - Zip Code:03263-3403
Practice Address - Country:US
Practice Address - Phone:603-435-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant