Provider Demographics
NPI:1326808627
Name:BECK, DARLENE JOLYNN
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:JOLYNN
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DARLENE
Other - Middle Name:JOLYNN
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1570 WILMINGTON DR STE 220
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8773
Mailing Address - Country:US
Mailing Address - Phone:206-453-4888
Mailing Address - Fax:
Practice Address - Street 1:1570 WILMINGTON DR STE 220
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-8773
Practice Address - Country:US
Practice Address - Phone:206-453-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician