Provider Demographics
NPI:1467288100
Name:BEAVER, EMMA JOYCE MARY (AUD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:JOYCE MARY
Last Name:BEAVER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 RIVA RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1839
Mailing Address - Country:US
Mailing Address - Phone:614-282-2037
Mailing Address - Fax:
Practice Address - Street 1:839 RIVA RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1839
Practice Address - Country:US
Practice Address - Phone:614-282-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02443231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist