MEDICARE: MS. BETH L DULL 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
1	235Z00000X	Speech-Language Pathologist	SP.5076	OH

General Provider Information

NPI Number	:	1982989323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH L DULL CCC-SLP

Provider Business Mailing Address
First Line	:	1240 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-484-3014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-484-3014
Fax Number	:

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

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	10/17/2011

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Directions to “ MS. BETH L DULL CCC-SLP” Practice Location

Language	Start Address	Practice Location

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