Individual
WILLIS JEROME BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MC
Contact information
Practice address
5055 S MISSION RD, 4302, TUCSON, AZ 85746
(520) 314-0387
Mailing address
5055 S MISSION RD, 4302, TUCSON, AZ 85746
(520) 314-4307
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-21201
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
307442
MHN
AZ
Enumeration date
02/05/2007
Last updated
10/09/2025
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