Provider Demographics
NPI:1043922446
Name:WEEKES, BEVERLY GAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:GAY
Last Name:WEEKES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 KINGLET DR # 1675
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-8202
Mailing Address - Country:US
Mailing Address - Phone:941-380-1880
Mailing Address - Fax:
Practice Address - Street 1:1518 KINGLET DR
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-8202
Practice Address - Country:US
Practice Address - Phone:941-380-1880
Practice Address - Fax:941-505-2107
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103T00000X
COPSY.0001591103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist