| Doctor Name: | DR. JOHN MICHAEL BEERY |
| NPI Number: | 1629065412 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 5949857-2501 |
| Business Practice Address: | 75th Mdos/sgohm 7309 11th Street Hill Afb, UT - 84056 |
| Business Phone Number: | 8017777909 |
| Business Fax Number: | 8017774490 |
| Mailing Address: | 75 Mdos/sgohm, 7309 11th Street HILL AFB |
| State: | UT |
| Postal Code: | 84056 |
| Phone Number: | 8017777909 |
| Fax Number: | 8017774490 |
| NPI Enumeration Date: | 10/05/2005 |
| NPI Last Update Date: | 07/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 5949857-2501 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |