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1902937261
TERRY PAT BEAVERSON
RUSSELLVILLE, AR
NPI
1902937261
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AR 1886-C)
Enumeration Date
2007-03-08
Last Update Date
2011-11-03
Business Address
Mr. TERRY PAT BEAVERSON LCSW
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-967-5570
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Mailing Address
Mr. TERRY PAT BEAVERSON LCSW
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
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