Individual
BEVERLY A HAVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1035 N MAIN ST, RICE LAKE, WI 54868-1260
(715) 234-4313
(715) 736-0194
Mailing address
1035 N MAIN ST, RICE LAKE, WI 54868-1260
(715) 234-4313
(715) 736-0194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2026-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39232800
—
WI
Enumeration date
12/19/2006
Last updated
07/09/2007
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