Beasley, Jesse Blake
Beasley, Jesse Blake is an sole proprietor health care provider with primary practice located at 500 Spring St Se Ste 101 , Gainesville GA 30501-3773. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Beasley, Jesse Blake can be contacted via phone (770) 615-7676.Contact Information
Primary practice address
500 Spring St Se Ste 101
Gainesville GA 30501-3773
Phone: (770) 615-7676
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP010688 | Georgia |
Profile Details
| NPI number | 1295385607 |
|---|---|
| LBN Legal business name | Beasley, Jesse Blake |
| Credentials | CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 17th, 2019 |
| Last updated | Sep 17th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295385607 | NPPES |
| Georgia | MEDICAID | 841619876 |
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