Provider Demographics
NPI:1720626880
Name:HALL, BETH ELLEN (MED,CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ELLEN
Last Name:HALL
Suffix:
Gender:F
Credentials:MED,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BRUSHY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1020
Mailing Address - Country:US
Mailing Address - Phone:561-236-8861
Mailing Address - Fax:
Practice Address - Street 1:343 PRADO WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6512
Practice Address - Country:US
Practice Address - Phone:864-270-8647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6439235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist