Provider Demographics
NPI:1982989323
Name:DULL, BETH L (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:L
Last Name:DULL
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 1:1240 HERSCHEL WOODS LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-4335
Mailing Address - Country:US
Mailing Address - Phone:513-484-3014
Mailing Address - Fax:
Practice Address - Street 1:1240 HERSCHEL WOODS LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-4335
Practice Address - Country:US
Practice Address - Phone:513-484-3014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.5076235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist