Provider Demographics
NPI:1518679208
Name:LEE, BETHANY JING-CHING (CCC-SLP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JING-CHING
Last Name:LEE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 E BELL RD STE 45-497
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2308
Mailing Address - Country:US
Mailing Address - Phone:602-888-4058
Mailing Address - Fax:
Practice Address - Street 1:4727 E BELL RD STE 45-497
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2308
Practice Address - Country:US
Practice Address - Phone:602-888-4058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP14305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist