Doctor Name: | MR. DAVID R. BEACH |
NPI Number: | 1457535981 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 6401008508 |
Business Practice Address: | 7860 Morrison Lake Rd Saranac, MI - 488819610 |
Business Phone Number: | 6167062521 |
Business Fax Number: | |
Mailing Address: | 11689 Tj Ln, LOWELL |
State: | MI |
Postal Code: | 493318775 |
Phone Number: | 6167062521 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2007 |
NPI Last Update Date: | 01/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401008508 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |