Provider Demographics
NPI:1881475432
Name:BEASLEY, LAYNE MICHELE
Entity type:Individual
Prefix:
First Name:LAYNE
Middle Name:MICHELE
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 1:32 EAGLES VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW RINGGOLD
Mailing Address - State:PA
Mailing Address - Zip Code:17960
Mailing Address - Country:US
Mailing Address - Phone:610-295-8293
Mailing Address - Fax:
Practice Address - Street 1:526 WOOD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-4453
Practice Address - Country:US
Practice Address - Phone:610-625-4885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation