Provider Demographics
NPI:1043095953
Name:BEOUGHER, NATALY MICHELLE
Entity Type:Individual
Prefix:
First Name:NATALY
Middle Name:MICHELLE
Last Name:BEOUGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15856 WILMAGLEN DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-3560
Mailing Address - Country:US
Mailing Address - Phone:562-237-3434
Mailing Address - Fax:
Practice Address - Street 1:7630 PAINTER AVE STE B
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2373
Practice Address - Country:US
Practice Address - Phone:800-807-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst