Provider Demographics
NPI:1396935235
Name:BEASLEY, JULIE AMANDA (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:AMANDA
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1121
Mailing Address - Country:US
Mailing Address - Phone:806-725-8082
Mailing Address - Fax:806-723-6145
Practice Address - Street 1:4101 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1121
Practice Address - Country:US
Practice Address - Phone:806-725-8082
Practice Address - Fax:806-723-6145
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS