Individual
MRS. BETH KAROL MAROTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
700 S BOARDMAN AVE, GALLUP, NM 87301-4707
(505) 721-1011
Mailing address
401 VANDEN BOSCH PKWY, GALLUP, NM 87301-4533
(505) 722-8456
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1699
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75912
—
NM
Enumeration date
03/19/2007
Last updated
07/08/2007
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