Provider Demographics
NPI:1457890873
Name:YOUMANS, BEVEISHA
Entity Type:Individual
Prefix:
First Name:BEVEISHA
Middle Name:
Last Name:YOUMANS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BEVEISHA
Other - Middle Name:
Other - Last Name:YOUMANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HAIR LOSS SPECIALST
Mailing Address - Street 1:3542 COVENANT ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204
Mailing Address - Country:US
Mailing Address - Phone:803-238-0966
Mailing Address - Fax:
Practice Address - Street 1:3542 COVENANT RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4271
Practice Address - Country:US
Practice Address - Phone:803-238-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC315651744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management