Doctor Name: | DR. BERDENA J. BEACH |
NPI Number: | 1093726994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., LMFT, LMHC |
License Number: | 00012 |
Business Practice Address: | 324 W 3rd St Cedar Falls, IA - 506132761 |
Business Phone Number: | 3192774383 |
Business Fax Number: | 3192682207 |
Mailing Address: | 324 W 3rd St, CEDAR FALLS |
State: | IA |
Postal Code: | 506132761 |
Phone Number: | 3192774383 |
Fax Number: | 3192682207 |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 00012 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |