| NPI | 1619325123 |
|---|---|
| Former Legal Business Name | RUSSELL BEAZER THERAPIST LLC |
| Entity Type | Organization |
| Authorized Contact | RUSSELL BEAZER Owner / Psychotherapist 480-649-6499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT10047) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |