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CAROLINE BEAUREGARD
School >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1376970582
Individual Registrant: CAROLINE BEAUREGARD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
3203 MIDDLE ST SULLIVANS ISLAND, SC 29482-8650 US
Tel: 303-588-9511 Fax: --
Tel: 303-588-9511 Fax: --
Contact information for business:
3203 MIDDLE ST SULLIVANS ISLAND, SC 29482-8650 US
Tel: 303-588-9511 Fax: --
Tel: 303-588-9511 Fax: --
Registration Information:
NPI: 1376970582
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TS0200X | Behavioral Health & Social Service Providers Psychologist School |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1588615918 | SC | 05 |
