Provider Demographics
NPI:1033449475
Name:BECK, MARA NEWMAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARA
Middle Name:NEWMAN
Last Name:BECK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 SHADOW RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3821
Mailing Address - Country:US
Mailing Address - Phone:310-701-8315
Mailing Address - Fax:
Practice Address - Street 1:7111 SHADOW RIDGE CT
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3821
Practice Address - Country:US
Practice Address - Phone:310-701-8315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP9886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist