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General NPI Number Information
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NPI Number | 1306672399
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Entity Type | Individual
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Provider Name | ASHLEY BEASLEY ALLISON IMH
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 600 S MAIN AVE
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City | MINNEOLA
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State | FL
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Zip | 34715-9578
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Country | US
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Telephone | 407-399-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 13049 BAYBROOK LN
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City | CLERMONT
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State | FL
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Zip | 34711-6614
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Country | US
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Telephone | 407-567-8960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 26001
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License Number State | FL
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