Provider Demographics
NPI:1598043952
Name:BEESON, PELAGIE M (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:PELAGIE
Middle Name:M
Last Name:BEESON
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0071
Mailing Address - Country:US
Mailing Address - Phone:520-621-9879
Mailing Address - Fax:520-621-9901
Practice Address - Street 1:1131 E 2ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0071
Practice Address - Country:US
Practice Address - Phone:520-621-9879
Practice Address - Fax:520-621-9901
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist