Doctor Name: | DR. MIRIAM E BEADLE |
NPI Number: | 1669445821 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | PSY1000047 |
Business Practice Address: | 3000 Connecticut Ave Nw Suite #136 Washington, DC - 200082509 |
Business Phone Number: | 2025365602 |
Business Fax Number: | 2022631168 |
Mailing Address: | Po Box 638, COLUMBIA |
State: | MD |
Postal Code: | 210450638 |
Phone Number: | 2025365602 |
Fax Number: | 2022631168 |
NPI Enumeration Date: | 02/08/2006 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY1000047 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |