| Doctor Name: | MS. BEVERLY ANN GARDNER-NELSON |
| NPI Number: | 1093865065 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-AP, LCDC, CCJP |
| License Number: | S06143 |
| Business Practice Address: | 9000 Frey Rd Houston, TX - 770343506 |
| Business Phone Number: | 7138515302 |
| Business Fax Number: | 2814648683 |
| Mailing Address: | 11717 Beamer Rd, Apt. 245 HOUSTON |
| State: | TX |
| Postal Code: | 770893100 |
| Phone Number: | 2814811774 |
| Fax Number: | 2814648683 |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 09/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | S06143 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |