Provider Demographics
NPI:1821510520
Name:BEASLEY, SHAWNA JOSETTE
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:JOSETTE
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E HAMPDEN AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2770
Mailing Address - Country:US
Mailing Address - Phone:303-783-9220
Mailing Address - Fax:
Practice Address - Street 1:601 E HAMPDEN AVE STE 430
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2770
Practice Address - Country:US
Practice Address - Phone:303-783-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000875231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist