Individual
DR. KENNETH ALLEN BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1115 BETHEL RD, COLUMBUS, OH 43220-2690
(614) 459-3003
(614) 451-3017
Mailing address
1115 BETHEL RD, COLUMBUS, OH 43220-2690
(614) 459-3003
(614) 451-3017
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4271
OH
Other
Enumeration date
12/28/2005
Last updated
07/08/2007
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