Provider Demographics
NPI:1104522374
Name:BEEGHLY, KRISTEN M
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:BEEGHLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4276 E CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45370-7783
Mailing Address - Country:US
Mailing Address - Phone:513-824-1805
Mailing Address - Fax:
Practice Address - Street 1:4276 E CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:OH
Practice Address - Zip Code:45370-7783
Practice Address - Country:US
Practice Address - Phone:513-824-1805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH-05674225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist