Doctor Name: | MINNA R BEAM |
NPI Number: | 1013034362 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701003660 |
Business Practice Address: | 770 W Ridge Rd Wytheville, VA - 243821046 |
Business Phone Number: | 2762233206 |
Business Fax Number: | 2762230617 |
Mailing Address: | 770 W Ridge Rd, WYTHEVILLE |
State: | VA |
Postal Code: | 243821046 |
Phone Number: | 2762233206 |
Fax Number: | 2762230617 |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 11/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0701003660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |