Provider Demographics
NPI:1417278110
Name:BECK, MARTHA ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ELIZABETH
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 1:22 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-1414
Mailing Address - Country:US
Mailing Address - Phone:607-753-0237
Mailing Address - Fax:
Practice Address - Street 1:1710 RTE 13 N
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-9618
Practice Address - Country:US
Practice Address - Phone:607-758-5215
Practice Address - Fax:607-758-5245
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010257-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist