Individual
MADISON GRACE BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 LINDELL RD, LAS VEGAS, NV 89146-6815
(702) 203-4353
Mailing address
9881 LAKE AUSTIN CT, LAS VEGAS, NV 89148-4759
(702) 901-2850
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10768-M
NV
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/30/2018
Last updated
09/22/2023
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