Individual
BEVERLY LETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
27904 JOHN F KENNEDY DR, UNIT C, MORENO VALLEY, CA 92555-5873
(951) 242-2196
Mailing address
27904 JOHN F KENNEDY DR, UNIT C, MORENO VALLEY, CA 92555-5873
(951) 242-2196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22001045A
IN
235Z00000X
Speech-Language Pathologist
Primary
SP 14169
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22001045A
INDIANA LICENSURE AS A SPEECH/LANGUAGE PATHOLOGIST
IN
01
—
SP 14169
CALIFORNIA LICENSURE AS A SPEECH/LANGUAGE PATHOLOGIST
CA
Enumeration date
11/06/2013
Last updated
11/06/2013
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