Individual
KELLY BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
158 ACADEMY LN, PENCE SPRINGS, WV 24962
(304) 445-7790
Mailing address
PO BOX 798, ALDERSON, WV 24910-0798
(304) 445-7790
(866) 603-3030
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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