Individual
BRENDA BEVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1190 WEST, 1190 WEST SUITE 812, JACKSON, MI 49202
(517) 513-3657
(517) 513-3693
Mailing address
3817 LONE PINE DR APT 2, HOLT, MI 48842-8800
(989) 233-1020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2-00945
MI
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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