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Individual
BEVERLY MICHAEL
Active
Individual
BEVERLY MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
I-06355
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24331350
—
NM
Enumeration date
03/19/2007
Last updated
11/17/2007
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