Individual
HEATHER LORAE BEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4061 SUZANNE DR STE C&D, DIBERVILLE, MS 39540-3735
(228) 396-4434
(228) 396-4438
Mailing address
4061 SUZANNE DR STE C&D, DIBERVILLE, MS 39540-3735
(228) 396-4434
(228) 396-4438
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-95011
MS
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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