Provider Demographics
NPI:1184863763
Name:BECK, MICHELLE ELAINE (MA)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ELAINE
Last Name:BECK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5452 GLEN LAKES DR STE 201
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0910
Mailing Address - Country:US
Mailing Address - Phone:972-569-7141
Mailing Address - Fax:214-346-0477
Practice Address - Street 1:5452 GLEN LAKES DR STE 201
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0910
Practice Address - Country:US
Practice Address - Phone:972-569-7141
Practice Address - Fax:214-346-0477
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst