Provider Demographics
NPI:1750480257
Name:BEATTY-TAYLOR, DAWN R (MC LPC)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:R
Last Name:BEATTY-TAYLOR
Suffix:
Gender:F
Credentials:MC LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4111 E VALLEY AUTO DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4609
Mailing Address - Country:US
Mailing Address - Phone:480-775-3528
Mailing Address - Fax:480-813-2987
Practice Address - Street 1:4111 E VALLEY AUTO DR
Practice Address - Street 2:SUITE 201D
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4605
Practice Address - Country:US
Practice Address - Phone:480-775-3528
Practice Address - Fax:480-813-2987
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZLPC-10886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional