Individual
MISS BEVERLY LOUISE HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
401 S 400 E, BEVERLY HOMER MOUNTAIN LAND REHABILITATION, BOUNTIFUL, UT 84010
(801) 397-8151
(801) 397-8051
Mailing address
401 S 400 E, BEVERLY HOMER MOUNTAIN LAND REHABILITATION, BOUNTIFUL, UT 84010
(801) 397-8163
(801) 397-8051
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5870932-4102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6276
—
UT
Enumeration date
11/17/2006
Last updated
07/08/2007
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