Healthcare Provider Details
I. General information
NPI: 1639712961
Provider Name (Legal Business Name): KRISTA MARIE BEY MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/18/2019
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15820 ADDISON RD
ADDISON TX
75001-3549
US
IV. Provider business mailing address
6415 GLADEHILL DR
KINGWOOD TX
77345-2503
US
V. Phone/Fax
- Phone: 214-575-2999
- Fax:
- Phone: 832-209-6605
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 17771 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: