Provider Demographics
NPI:1285059857
Name:WHITMIRE, BETH BARRON (MED, CCC, SLP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:BARRON
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:MED, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4243
Mailing Address - Country:US
Mailing Address - Phone:678-429-0272
Mailing Address - Fax:678-289-8533
Practice Address - Street 1:261 MONTROSE DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4243
Practice Address - Country:US
Practice Address - Phone:678-429-0272
Practice Address - Fax:678-289-8533
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP000475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist