Most Relevant Information
Provider Data
| NPI Number: | 1003434333 |
| Provider Name: | DESIREE BEASLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/13/2020 |
| Last Updated: | 07/13/2020 |
Provider Practice Location
9120 SPRINGBROOK DR NW
COON RAPIDS
MN
554335845
Practice Location Phone/Fax
| Phone: | 9527677222 |
| Fax: |
Provider Mailing Location
9120 SPRINGBROOK DR NW
COON RAPIDS
MN
554335845
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |