Individual
BONNY MARGUERITE BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
1648 S 16TH ST, PHOENIX, AZ 85034-5340
(602) 448-0935
(602) 532-7202
Mailing address
4205 N 2ND DR, PHOENIX, AZ 85013-3027
(602) 448-0935
(602) 532-7202
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LISAC 11484
AZ
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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