Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC-1768 | AZ |
NPI | 1003326638 |
---|---|
Provider Name | Margaret Ann Beresford |
First Address | Phoenix, AZ 85018-5344 |
Second Address | Phoenix, AZ 85018-5473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2017 |
Last Update Date | 06/03/2020 |