Doctor Name: | BONNY MARGUERITE BEACH |
NPI Number: | 1578999041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISAC |
License Number: | LISAC 11484 |
Business Practice Address: | 1648 S 16th St Phoenix, AZ - 850345340 |
Business Phone Number: | 6024480935 |
Business Fax Number: | 6025327202 |
Mailing Address: | 4205 N 2nd Dr, PHOENIX |
State: | AZ |
Postal Code: | 850133027 |
Phone Number: | 6024480935 |
Fax Number: | 6025327202 |
NPI Enumeration Date: | 09/17/2013 |
NPI Last Update Date: | 09/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LISAC 11484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |