Beverly, Timothy Ray

Beverly, Timothy Ray is an individual health care provider with primary practice located at 302 W Main St , Fairborn OH 45324-5037. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Beverly, Timothy Ray can be contacted via phone (937) 281-4673.

Contact Information

Primary practice address
302 W Main St Fairborn OH 45324-5037
Phone: (937) 281-4673
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 070488 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDCII.161829 Ohio

Profile Details

NPI number 1194211409
LBN Legal business name Beverly, Timothy Ray
Credentials CDCA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2018
Last updated Jan 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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