Provider Demographics
NPI:1740838721
Name:MUSKOPF, BEVERLY KAYE (PLPC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:KAYE
Last Name:MUSKOPF
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2721
Mailing Address - Country:US
Mailing Address - Phone:314-739-6811
Mailing Address - Fax:314-739-6325
Practice Address - Street 1:11300 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2721
Practice Address - Country:US
Practice Address - Phone:314-739-6811
Practice Address - Fax:314-739-6325
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor