Provider Demographics
NPI:1669126892
Name:LEVY, BETH C (MS, SLP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:C
Last Name:LEVY
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 CYPRESS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-3198
Mailing Address - Country:US
Mailing Address - Phone:561-373-4697
Mailing Address - Fax:
Practice Address - Street 1:1660 CYPRESS DR STE 3
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33469-3198
Practice Address - Country:US
Practice Address - Phone:561-629-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15478749OtherCAQH