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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952440299 NPPES
Arizona Other 307442 MHN

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