| Doctor Name: | JENNIFER BEVARD |
| NPI Number: | 1144696402 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 489 Main St Prince Frederick, MD - 206783187 |
| Business Phone Number: | 4105353047 |
| Business Fax Number: | 4105353890 |
| Mailing Address: | 489 Main St, PRINCE FREDERICK |
| State: | MD |
| Postal Code: | 206783187 |
| Phone Number: | 4105353047 |
| Fax Number: | 4105353890 |
| NPI Enumeration Date: | 08/20/2015 |
| NPI Last Update Date: | 08/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |