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Individual

HEATHER D BEISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSCC

Contact information

Practice address
1012 W COLUMBIA ST, FARMINGTON, MO 63640-2914
(573) 218-7100
Mailing address
8 WOODCHASE DR APT 63, FARMINGTON, MO 63640-1421
(573) 366-0292
(573) 883-7537

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
2019006197
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346733037
MO
Enumeration date
06/07/2018
Last updated
08/11/2021
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