Beverly G Dedual
Individual provider Active NPI Athletic Trainer · Saucier, MS
NPI 1932825809 · NPPES record last updated Jan 11, 2024
Key facts
- NPI
- 1932825809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1124 (MS)
- Practice address
- 18114 S Village Dr
Saucier, MS 39574-6520 - Phone
- (228) 263-4352
- NPI assigned
- Oct 12, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1124 | MS | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1124 | MS | Yes |
Addresses
Primary practice location
18114 S Village Dr
Saucier, MS 39574-6520
Mailing address
18114 S Village Dr
Saucier, MS 39574-6520
Phone (228) 263-4352
Other providers in Saucier, MS
- Cares Center Inc
- Caring Hearts Counseling Services, LLC
- Coastal Family Health Center
- Coastal Family Health Center Inc
- Carrie Dawson
- Meghan Brown Dye
- Christine Gibson
- Gulf Coast Education Solutions
- Gulf Coast Education Solutions, LLC
- Gulf Coast Education Solutions, LLC
All providers in Saucier, MS · Athletic Trainer in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.