MEDICARE: BETH BELLOWS

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		MN

General Provider Information

NPI Number	:	1790617116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH BELLOWS

Provider Business Mailing Address
First Line	:	6519 UPPER 14TH ST N
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-4519
Country	:	US
Telephone Number	:	651-285-0594
Fax Number	:

Provider Business Practice Location Address
First Line	:	3764 95TH AVE NE
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-3849
Country	:	US
Telephone Number	:	651-415-6224
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ BETH BELLOWS ” Practice Location

Language	Start Address	Practice Location

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