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Individual

KAYSE FIELDS BEASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
105 FLORIDA AVE, CAROLINA BEACH, NC 28428-5802
(252) 717-8005
(877) 335-6220
Mailing address
105 FLORIDA AVE UNIT 2, CAROLINA BEACH, NC 28428-5802
(252) 717-8005
(877) 335-6220

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5465
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7411855
NC
Enumeration date
12/12/2006
Last updated
05/09/2022
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