Provider Demographics
NPI:1598997652
Name:BECKER, BENJAMIN (MA, BSL)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:MA, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 CREAMERY WAY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2508
Mailing Address - Country:US
Mailing Address - Phone:717-413-1334
Mailing Address - Fax:
Practice Address - Street 1:467 CREAMERY WAY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2508
Practice Address - Country:US
Practice Address - Phone:717-413-1334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002731103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst