Individual
MS. BEVERLY A HOLDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T., M.M.P.
Contact information
Practice address
4212 W CREEDANCE BLVD, GLENDALE, AZ 85310-4072
(623) 780-7598
Mailing address
4212 W CREEDANCE BLVD, GLENDALE, AZ 85310-4072
(623) 780-7598
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT 05786
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
448408 00
NATIONAL CERTIFICATION BOARD OF THERAPEUTIC MASSAGE AND BODYWORK
—
01
—
MT 05786
LICENSED MASSAGE THERAPIST
—
Enumeration date
10/21/2008
Last updated
10/21/2008
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