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Individual

DR. MARYANN BELTRAN THIRAKUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD.

Contact information

Practice address
2266 S. DOBSON RD., SUITE 200, MESA, AZ 85202
(480) 775-5154
(480) 744-2726
Mailing address
1830 S ALMA SCHOOL RD STE 104, MESA, AZ 85210-3086
(480) 344-7088
(480) 744-2726

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3783
AZ
103TC1900X
Counseling Psychologist
3783
AZ
103TC2200X
Clinical Child & Adolescent Psychologist
3783
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140717
AZ
Enumeration date
12/04/2006
Last updated
02/03/2022
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