MEDICARE: LINDSAY DAWN BEESLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1588041230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY DAWN BEESLEY

Provider Business Mailing Address
First Line	:	PO BOX 595
Second Line	:
City	:	EPHRAIM
State	:	UT
Zip	:	84627-0595
Country	:	US
Telephone Number	:	435-462-3209
Fax Number	:	435-283-4689

Provider Business Practice Location Address
First Line	:	45 WEST 700 SOUTH
Second Line	:
City	:	EPHRAIM
State	:	UT
Zip	:	84627-1524
Country	:	US
Telephone Number	:	435-283-4690
Fax Number	:	435-283-4689

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	05/01/2015

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Directions to “ LINDSAY DAWN BEESLEY ” Practice Location

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