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General NPI Number Information
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NPI Number | 1972946622
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Entity Type | Individual
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Provider Name | PATRICIA J BEAVERS SLP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2000 BEAR CAT WAY STE 105
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City | MORRISVILLE
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State | NC
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Zip | 27560-6620
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Country | US
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Telephone | 919-593-8104
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Fax | 919-777-0499
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Provider Business Mailing Address
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Address Line | 4828 GREENSHADOW CT
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-8683
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Country | US
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Telephone | 919-593-8104
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Fax | 919-822-8110
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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 | 10317
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License Number State | NC
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