Provider Demographics
NPI:1720471915
Name:BEATTY, ARIELLE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 GUEST DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1473
Mailing Address - Country:US
Mailing Address - Phone:732-972-4281
Mailing Address - Fax:
Practice Address - Street 1:1 DAVID BRAINERD DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-1927
Practice Address - Country:US
Practice Address - Phone:732-521-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00770100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist