MEDICARE: CLAIRE ELISE VAN BEEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	05268	MD

General Provider Information

NPI Number	:	1881163038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE ELISE VAN BEEK

Provider Business Mailing Address
First Line	:	20343 HERMANVILLE RD
Second Line	:
City	:	PARK HALL
State	:	MD
Zip	:	20667-2729
Country	:	US
Telephone Number	:	301-863-4054
Fax Number	:

Provider Business Practice Location Address
First Line	:	20343 HERMANVILLE RD
Second Line	:
City	:	PARK HALL
State	:	MD
Zip	:	20667-2729
Country	:	US
Telephone Number	:	301-863-4054
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	11/16/2018

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Directions to “ CLAIRE ELISE VAN BEEK ” Practice Location

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