MEDICARE: BETHANY JANE FERGUSON

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1770428401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY JANE FERGUSON

Provider Business Mailing Address
First Line	:	1244 MAIN ST
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-4425
Country	:	US
Telephone Number	:	610-551-3217
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 ROHRERSTOWN RD
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-2274
Country	:	US
Telephone Number	:	717-666-3325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “ BETHANY JANE FERGUSON ” Practice Location

Language	Start Address	Practice Location

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