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Individual

DR. BEVERLY PONDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1536 N BOULDER HWY, HENDERSON, NV 89011-4120
(702) 558-8600
(702) 558-8700
Mailing address
1536 N BOULDER HWY, HENDERSON, NV 89011-4120
(702) 558-8600
(702) 558-8700

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057830456
DRIVERS LICENSE
GA
Enumeration date
01/09/2019
Last updated
02/17/2021
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