Basic Information
| Provider Information | |||||||||
| NPI: | 1871595926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHINERY | ||||||||
| FirstName: | BETH | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608A EUSTIS ST | ||||||||
| Address2: | #302 | ||||||||
| City: | LAUDERDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551081253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6516036925 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9220 BASS LAKE RD | ||||||||
| Address2: | SUITE 260 | ||||||||
| City: | NEW HOPE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554283000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635330363 | ||||||||
| FaxNumber: | 7635330842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7452 | MN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.