Individual
LEEANNE M BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
172 REGATTA DR, BRANDON, MS 39047-7046
(601) 503-6112
Mailing address
102 BRISCO ST, MADISON, MS 39110-4601
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2110
MS
Other
Enumeration date
09/05/2016
Last updated
12/26/2018
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