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NPI Code Detail

MEDICARE: DR. JULIE FOUTZ BEASLEY PH.D.

MEDICARE:  DR. JULIE FOUTZ BEASLEY  PH.D.
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
1103TC2200XClinical Child & Adolescent PsychologistPY0376NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659587426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE FOUTZ BEASLEY PH.D.
Provider Business Mailing Address
First Line : 3016 W CHARLESTON BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1973
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 630 S RANCHO DR STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4849
Country : US
Telephone Number : 702-998-9505
Fax Number : 702-527-7939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 06/09/2020

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Directions to “ DR. JULIE FOUTZ BEASLEY PH.D.” Practice Location

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