Individual
DR. DENNIS MICHAEL BEAUFAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED D
Contact information
Practice address
119 E MARCY ST STE 202, SANTA FE, NM 87501-2046
(888) 982-3113
Mailing address
PO BOX 32390, SANTA FE, NM 87594-2390
(888) 982-3113
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
005152
MI
103TC0700X
Clinical Psychologist
Primary
2857
CO
103TC1900X
Counseling Psychologist
4114
AZ
Other
Enumeration date
08/25/2006
Last updated
10/24/2016
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