Provider Demographics
NPI:1073112181
Name:PRIOR, BEATRICE TAUBER
Entity Type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:TAUBER
Last Name:PRIOR
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 1:17505 W CATAWBA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8065
Mailing Address - Country:US
Mailing Address - Phone:704-940-1822
Mailing Address - Fax:
Practice Address - Street 1:17505 W CATAWBA AVE STE 100
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8065
Practice Address - Country:US
Practice Address - Phone:704-940-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3144103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical