Individual
LYNN L BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
164 STATE HIGHWAY 83, DEFUNIAK SPRINGS, FL 32433-7428
(850) 902-9445
(850) 373-4906
Mailing address
164 STATE HIGHWAY 83, DEFUNIAK SPRINGS, FL 32433-7428
(850) 902-9445
(850) 373-4906
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
S-2400
FL
Other
Enumeration date
09/14/2018
Last updated
01/16/2024
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