Provider Demographics
NPI:1386810737
Name:MANN, BETH PUFFENBERGER
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:PUFFENBERGER
Last Name:MANN
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 1:601 KEISLER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6566
Mailing Address - Country:US
Mailing Address - Phone:919-859-4744
Mailing Address - Fax:919-859-9406
Practice Address - Street 1:601 KEISLER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6566
Practice Address - Country:US
Practice Address - Phone:919-859-4744
Practice Address - Fax:919-859-9406
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1902231H00000X
NC668237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter