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General NPI Number Information
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NPI Number | 1053420224
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Entity Type | Individual
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Provider Name | BEVERLY JOLENE SEABOURN M.S.,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1108 ABBOTS LN
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City | DENTON
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State | TX
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Zip | 76205-8049
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Country | US
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Telephone | 940-382-2736
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Fax | 940-382-1317
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Provider Business Mailing Address
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Address Line | 1108 ABBOTS LN
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City | DENTON
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State | TX
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Zip | 76205-8049
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Country | US
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Telephone | 940-382-2736
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Fax | 940-382-1317
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12340
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License Number State | TX
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