Darla K. Bethke, CCC-SP
Speech-Language Pathologist, in Orange, CA. Individual provider (NPI-1).
NPI number1619219490
StatusActive
Last updated in NPPESMar 20, 2013
Details
- NPI
- 1619219490
- Entity type
- Individual (NPI-1)
- Name
- Darla K. Bethke
- Credential
- CCC-SP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 20, 2013
- Last updated
- Mar 20, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | SP5328 | CA | Yes |
| 261Q00000X | Clinic/Center | 956154473 | CA |
Practice location
1301 W Providence AveOrange, CA 92868-3808
Phone 714-639-4990
Mailing address
22706 Islamare LnLake Forest, CA 92630-3634
Phone 949-859-8158
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