| NPI | 1295300572 |
|---|---|
| Former Name | STEPHANIE BEASLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1345915) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1345915) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-08-28 |