Provider Demographics
NPI:1306272133
Name:KANNING, BETHANN KAY (MSCCC/SLP)
Entity type:Individual
Prefix:MS
First Name:BETHANN
Middle Name:KAY
Last Name:KANNING
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0665
Mailing Address - Country:US
Mailing Address - Phone:701-412-5000
Mailing Address - Fax:
Practice Address - Street 1:1655 SHILOH RD STE D
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-1726
Practice Address - Country:US
Practice Address - Phone:406-969-2770
Practice Address - Fax:406-969-1340
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-LIC-8113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist