Provider Demographics
NPI:1861657207
Name:DAFLER, BEVERLY DEE (LPC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:DEE
Last Name:DAFLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 TALLENT ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5562
Mailing Address - Country:US
Mailing Address - Phone:605-718-2094
Mailing Address - Fax:
Practice Address - Street 1:148 TALLENT ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5562
Practice Address - Country:US
Practice Address - Phone:605-718-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health