| Doctor Name: | BETSY ELIZABETH BERTHOLF |
| NPI Number: | 1003128687 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 13142 |
| Business Practice Address: | 1201 N Raul Longoria Rd Suite P San Juan, TX - 785893727 |
| Business Phone Number: | 2105201723 |
| Business Fax Number: | 2105201724 |
| Mailing Address: | Po Box 681271, SAN ANTONIO |
| State: | TX |
| Postal Code: | 782681271 |
| Phone Number: | 2105201723 |
| Fax Number: | 2105201724 |
| NPI Enumeration Date: | 07/12/2010 |
| NPI Last Update Date: | 09/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 13142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |