Provider Demographics
NPI:1780329193
Name:BEARD, RACHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 E THUNDERBIRD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5760
Mailing Address - Country:US
Mailing Address - Phone:481-848-4411
Mailing Address - Fax:
Practice Address - Street 1:1940 E THUNDERBIRD RD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5760
Practice Address - Country:US
Practice Address - Phone:481-848-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
AZPSY-005483103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist