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General NPI Number Information
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NPI Number | 1881222081
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Entity Type | Individual
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Provider Name | RONALD C BEAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 943 W OVERLAND RD STE 161
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City | MERIDIAN
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State | ID
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Zip | 83642-6541
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Country | US
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Telephone | 602-799-4929
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Fax | 602-775-2705
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Provider Business Mailing Address
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Address Line | 6026 N MOOSE CREEK WAY
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City | MERIDIAN
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State | ID
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Zip | 83646-5449
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Country | US
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Telephone | 602-799-4929
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Fax | 602-775-2705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY005246
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License Number State | AZ
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