Provider Demographics
NPI:1326055898
Name:BECK, SHIRLEY A (PT)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:BECK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 N FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-2549
Mailing Address - Country:US
Mailing Address - Phone:703-524-7252
Mailing Address - Fax:703-524-6820
Practice Address - Street 1:1126 N FREDERICK ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-2549
Practice Address - Country:US
Practice Address - Phone:703-524-7252
Practice Address - Fax:703-524-6820
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist