Basic Information
| Provider Information | |||||||||
| NPI: | 1235312182 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEORGER | ||||||||
| FirstName: | BETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 N ERIE ST | ||||||||
| Address2: | |||||||||
| City: | MAYVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147571090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7167534104 | ||||||||
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| Practice Location | |||||||||
| Address1: | 326 ORCHARD PARK RD | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142242635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168280560 | ||||||||
| FaxNumber: | 7168230751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2007 | ||||||||
| LastUpdateDate: | 09/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.