Beasley, Willis Jerome
Beasley, Willis Jerome is an individual health care provider with primary practice located at 333 W Wilcox Ste 303, Sierra Vista AZ 85635. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Beasley, Willis Jerome can be contacted via phone (520) 378-2613.Contact Information
Primary practice address
333 W Wilcox Ste 303
Sierra Vista AZ 85635
Phone: (520) 378-2613
Fax: (520) 458-5124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC10904 | Arizona |
Profile Details
| NPI number | 1952440299 |
|---|---|
| LBN Legal business name | Beasley, Willis Jerome |
| Credentials | MC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1952440299 | NPPES |
| Arizona | Other | 307442 | MHN |
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