Individual
MRS. MAUREEN G BEVERSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT.
Contact information
Practice address
131 KERCHEVAL AVE, SUITE 110, GROSSE POINTE FARMS, MI 48236-3629
(313) 640-2591
(313) 640-2589
Mailing address
21960 LESTER ST, CLINTON TWP, MI 48035-1736
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
221507051552616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221507051552616
PHARM CERTIFIED TECH
MI
Enumeration date
08/31/2006
Last updated
07/08/2007
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