Individual
BEVERLY MIRGEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3065 WILLIAM ST, SUITE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Mailing address
3065 WILLIAM ST, SUITE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003216
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417959149
—
MO
Enumeration date
10/10/2006
Last updated
09/12/2012
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