Doctor Name: | MRS. BEVERLY ANN FRATES MCMAHON |
NPI Number: | 1043385495 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS LMHP LADC |
License Number: | 403 |
Business Practice Address: | 319 East A St Suite B Ogallala, NE - 69153 |
Business Phone Number: | 3082846519 |
Business Fax Number: | 3082846513 |
Mailing Address: | 319 East A, Suite B OGALLALA |
State: | NE |
Postal Code: | 69153 |
Phone Number: | 3082846519 |
Fax Number: | 3082846513 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 403 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |