Provider Demographics
NPI:1730505587
Name:BEECH, ANNA (EDS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BEECH
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 COMMUNITY CIR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:OH
Mailing Address - Zip Code:44405-1482
Mailing Address - Country:US
Mailing Address - Phone:330-799-6324
Mailing Address - Fax:330-799-8259
Practice Address - Street 1:2002 COMMUNITY CIR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:OH
Practice Address - Zip Code:44405-1482
Practice Address - Country:US
Practice Address - Phone:330-799-6324
Practice Address - Fax:330-799-8259
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20943140103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool