Individual
MRS. BEVERLY RENE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
402 HARRIS AVE, RAEFORD, NC 28376-3112
(910) 848-1639
Mailing address
120 HIMALAYA DR, RAEFORD, NC 28376-8157
(910) 849-4566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2772A
NC
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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