| Doctor Name: | BETH WINEGAR |
| NPI Number: | 1225397102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | LMSW-31996 |
| Business Practice Address: | 218 Dividend Dr Ste 3 Rexburg, ID - 834403510 |
| Business Phone Number: | 2083599683 |
| Business Fax Number: | 2083599683 |
| Mailing Address: | 357 N 1587 E, SAINT ANTHONY |
| State: | ID |
| Postal Code: | 834455109 |
| Phone Number: | 2086240167 |
| Fax Number: | 2083599683 |
| NPI Enumeration Date: | 05/11/2012 |
| NPI Last Update Date: | 05/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LMSW-31996 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |