Individual
MR. RUSSELL GLEN BEAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1760 E BOSTON ST STE 102, GILBERT, AZ 85295-6241
(480) 649-6499
(480) 207-2580
Mailing address
1760 E BOSTON ST STE 102, GILBERT, AZ 85295-6241
(480) 649-6499
(480) 207-2580
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-10047
AZ
Other
Enumeration date
10/04/2006
Last updated
04/16/2020
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