Individual
BETHANY LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC/SLP
Contact information
Practice address
27 DAUGHERTY ST, BROOKVILLE, PA 15825-1049
(814) 229-1728
Mailing address
27 DAUGHERTY ST, BROOKVILLE, PA 15825-1049
(814) 229-1728
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL007925
PA
Other
Enumeration date
09/03/2009
Last updated
12/05/2023
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