Provider Demographics
NPI:1750975280
Name:KIRBY, BETHANY E (SLP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:E
Last Name:KIRBY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:E
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6701 N. CHARLES STREET
Mailing Address - Street 2:S. CHAPMAN BUILDING, SUITE 102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6569 N CHARLES ST STE 401
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5834
Practice Address - Country:US
Practice Address - Phone:443-849-2087
Practice Address - Fax:443-849-2649
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist