Individual
DR. PAMELA L BEVERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED. D., LPCC
Contact information
Practice address
3500 COMANCHE RD NE, SUITE 12, ALBUQUERQUE, NM 87107-4546
(505) 238-3449
Mailing address
PO BOX 2792, CORRALES, NM 87048-2792
(505) 238-3449
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0074101
NM
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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