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Individual
AMY LYNN BEAVER
Active
Individual
AMY LYNN BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II/QMHA-I
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-10-20
OR
101YM0800X
Mental Health Counselor
20-QMHA-I-03043
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500729432
—
OR
Enumeration date
07/13/2017
Last updated
08/25/2023
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