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NPI Code Detail

MEDICARE: BETH A CLARK TITZER MS, CCC-SLP

MEDICARE:   BETH A CLARK TITZER  MS, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist22002267AIN

General Provider Information

NPI Number : 1215131198
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH A CLARK TITZER MS, CCC-SLP
Provider Business Mailing Address
First Line : 3700 WASHINGTON AVE
Second Line :
City : EVANSVILLE
State : IN
Zip : 47750-0001
Country : US
Telephone Number : 812-485-5600
Fax Number :
Provider Business Practice Location Address
First Line : 1146 WASHINGTON SQ
Second Line :
City : EVANSVILLE
State : IN
Zip : 47715-6809
Country : US
Telephone Number : 812-485-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ BETH A CLARK TITZER MS, CCC-SLP” Practice Location

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