Provider Demographics
NPI:1629355995
Name:BECKER, ALICIA DAWN (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DAWN
Last Name:BECKER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12633 W CHERRY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-6336
Mailing Address - Country:US
Mailing Address - Phone:602-505-9272
Mailing Address - Fax:
Practice Address - Street 1:12375 W TURNEY AVE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4283
Practice Address - Country:US
Practice Address - Phone:602-690-1643
Practice Address - Fax:623-535-0632
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA74602355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant