| Doctor Name: | JANELLE PRUETT BEASLEY |
| NPI Number: | 1366864902 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SCHOOL PSYCHOLOGIST |
| License Number: | 4592 |
| Business Practice Address: | 770 Hagood Ave Barnwell, SC - 29812 |
| Business Phone Number: | 8035411331 |
| Business Fax Number: | 8035411324 |
| Mailing Address: | 2522 Curtis Dr, BARNWELL |
| State: | SC |
| Postal Code: | 29812 |
| Phone Number: | 8035411331 |
| Fax Number: | 8035411324 |
| NPI Enumeration Date: | 01/16/2014 |
| NPI Last Update Date: | 01/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 4592 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |