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General NPI Number Information
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NPI Number | 1861112724
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Entity Type | Individual
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Provider Name | AVERY CAROLINE BEEDY SLP
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Gender | Female
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 5550 HARVEST HILL RD
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City | DALLAS
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State | TX
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Zip | 75230-1684
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Country | US
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Telephone | 972-366-7374
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Fax |
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Provider Business Mailing Address
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Address Line | 5807 E UNIVERSITY BLVD APT D
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City | DALLAS
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State | TX
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Zip | 75206-4610
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Country | US
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Telephone |
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Fax |
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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 | 246Q00000X
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Taxonomy Name | Pathology Specialist/Technologist
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License Number | 111817
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License Number State | TX
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