Provider Demographics
NPI:1538370747
Name:ST. ONGE, BEVERLY ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANN
Last Name:ST. ONGE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 ALMA RD
Mailing Address - Street 2:APT. 1325
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1100
Mailing Address - Country:US
Mailing Address - Phone:860-942-9160
Mailing Address - Fax:
Practice Address - Street 1:3560 ALMA RD
Practice Address - Street 2:APT. 1325
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1100
Practice Address - Country:US
Practice Address - Phone:860-942-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist