Provider Demographics
NPI:1710975677
Name:BEAVER, HEIDI ALISON (MPH, CGC)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:ALISON
Last Name:BEAVER
Suffix:
Gender:F
Credentials:MPH, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 NORTH BALLAS ROAD
Mailing Address - Street 2:SUITE 630
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131
Mailing Address - Country:US
Mailing Address - Phone:314-996-6977
Mailing Address - Fax:314-747-0704
Practice Address - Street 1:3023 NORTH BALLAS ROAD
Practice Address - Street 2:SUITE 630
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-996-6977
Practice Address - Fax:314-747-0704
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS