Doctor Name: | MRS. BETH ELLEN GOERLITZ |
NPI Number: | 1689864142 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC., SLP |
License Number: | SA8700 |
Business Practice Address: | 305 Clyde Morris Blvd Ste 220 Ormond Beach, FL - 321748187 |
Business Phone Number: | 3866763130 |
Business Fax Number: | |
Mailing Address: | 5946 Park Ridge Dr, PORT ORANGE |
State: | FL |
Postal Code: | 321277547 |
Phone Number: | 3868462161 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2007 |
NPI Last Update Date: | 07/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA8700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |