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Individual

DR. JUDITH ANNE BEVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
40 SOUTH ST, SUITE 201, MARBLEHEAD, MA 01945-3282
(781) 599-6582
Mailing address
40 SOUTH ST, SUITE 201, MARBLEHEAD, MA 01945-3282
(781) 599-6582

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
4250
MA
103TC0700X
Clinical Psychologist
Primary
4250
MA
103TC2200X
Clinical Child & Adolescent Psychologist
4250
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0520217
MA
Enumeration date
03/07/2006
Last updated
04/01/2016
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