Doctor Name: | DR. ROGER LOUIS AVEYARD |
NPI Number: | 1275560310 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHP |
License Number: | 518 |
Business Practice Address: | 707 Court St. Beatrice, NE - 683103927 |
Business Phone Number: | 4022284968 |
Business Fax Number: | 4022283677 |
Mailing Address: | 707 Court St., BEATRICE |
State: | NM |
Postal Code: | 683103927 |
Phone Number: | 4022284968 |
Fax Number: | 4022283677 |
NPI Enumeration Date: | 06/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 518 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |