Provider Demographics
NPI:1740206648
Name:MURPHY, BETH A (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SW AURORA WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-0462
Mailing Address - Country:US
Mailing Address - Phone:386-961-9087
Mailing Address - Fax:
Practice Address - Street 1:203 SW AURORA WAY
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0462
Practice Address - Country:US
Practice Address - Phone:386-961-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 615235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist