Individual provider · NPI-1

Patrick Beasley

Speech-Language Pathologist, · Saint Clair Shores, MI

NPI number1073342499
StatusActive
Last updated in NPPESAug 1, 2024

Details

NPI
1073342499
Entity type
Individual (NPI-1)
Name
Patrick Beasley
Sex
Male
Sole proprietor
No
Enumeration date
Aug 1, 2024
Certification date
Aug 1, 2024
Last updated
Aug 1, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,7152000935MIYes

Practice location

21000 E 12 Mile Rd Ste 111
Saint Clair Shores, MI 48081-1156

Phone 586-779-7610

Mailing address

21000 E 12 Mile Rd Ste 111
Saint Clair Shores, MI 48081-1156

Phone 586-779-7610

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