Provider Demographics
NPI:1306075288
Name:DIEHL, BETH MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:MARIE
Last Name:DIEHL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SPARROW RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8833
Mailing Address - Country:US
Mailing Address - Phone:858-245-9614
Mailing Address - Fax:
Practice Address - Street 1:103 SPARROW RD
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8833
Practice Address - Country:US
Practice Address - Phone:858-245-9614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist