Individual
NICHOLAS V BEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLPA
Contact information
Practice address
4600 SW 74TH TER, DAVIE, FL 33314-4128
(317) 452-5395
Mailing address
4600 SW 74TH TER, DAVIE, FL 33314-4128
(317) 452-5395
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI 2490
FL
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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