Provider Demographics
NPI:1538530134
Name:BEHEREC, LISA A (CPM)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:BEHEREC
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:MILLHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:16854-0215
Mailing Address - Country:US
Mailing Address - Phone:814-404-4907
Mailing Address - Fax:
Practice Address - Street 1:143 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLHEIM
Practice Address - State:PA
Practice Address - Zip Code:16854-0215
Practice Address - Country:US
Practice Address - Phone:814-404-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife