Healthcare Provider Details

I. General information

NPI: 1023900065
Provider Name (Legal Business Name): LEAH BEASLEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 RHINO XING
MILAN TN
38358-5201
US

IV. Provider business mailing address

1307 HERRING DR
COVINGTON TN
38019-3009
US

V. Phone/Fax

Practice location:
  • Phone: 731-613-2214
  • Fax:
Mailing address:
  • Phone: 901-484-4197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8842
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: