Provider Demographics
NPI:1982098695
Name:BEASLEY, EMILY CATHERINE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
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 1:38 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2214
Mailing Address - Country:US
Mailing Address - Phone:781-812-5239
Mailing Address - Fax:
Practice Address - Street 1:38 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2214
Practice Address - Country:US
Practice Address - Phone:781-812-5239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst