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Individual

MRS. BETH R POE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCC-SLP

Contact information

Practice address
12276 SAN JOSE BLVD, JACKSONVILLE, FL 32223-8628
(904) 886-3228
Mailing address
4185 VENETIA BLVD, JACKSONVILLE, FL 32210-8505
(401) 864-8448

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00723
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26836
BCBS # FOR RI HOSPITAL
RI
01
409851
BCBS # FOR RIARC
RI
Enumeration date
07/09/2006
Last updated
10/21/2022
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