Provider Demographics
NPI:1083276422
Name:BECKER, DIANA ROSE (SLP)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:ROSE
Last Name:BECKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 BUNN DR STE A
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2859
Mailing Address - Country:US
Mailing Address - Phone:609-430-9200
Mailing Address - Fax:609-430-9202
Practice Address - Street 1:256 BUNN DR STE A
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2859
Practice Address - Country:US
Practice Address - Phone:609-430-9200
Practice Address - Fax:609-430-9202
Is Sole Proprietor?:No
Enumeration Date:2019-07-06
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL016049235Z00000X
GAPCET002911235Z00000X
NJ41YS01110600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist