Individual
KEESHA BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AMFT
Contact information
Practice address
1525 E 53RD ST STE 824, CHICAGO, IL 60615-4575
(773) 880-1310
Mailing address
1300 W BELMONT AVE STE 400, CHICAGO, IL 60657-3260
(773) 880-1310
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
208.000635
IL
Other
Enumeration date
02/04/2018
Last updated
03/17/2018
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