Lequita Beaton, M.S. ,ATC

Individual provider Active NPI Athletic Trainer · Pemberton, NJ

NPI 1497968085 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497968085
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
25MT00132200 (NJ)
Practice address
601 Pemberton Browns Mills Rd
Pemberton, NJ 08068-1536
Phone
(609) 894-9311
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
25MT00132200NJMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 25MT00132200 NJ Yes

Addresses

Primary practice location

601 Pemberton Browns Mills Rd
Pemberton, NJ 08068-1536

Mailing address

78 Catherine Dr
Franklinville, NJ 08322-2764

Other providers in Pemberton, NJ

All providers in Pemberton, NJ · Athletic Trainer in New Jersey

Sources for this page

Verify at the official NPI Registry.