Provider Demographics
NPI:1841572526
Name:BECKER, JAMELEY DIANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JAMELEY
Middle Name:DIANE
Last Name:BECKER
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 1:2926 SEATTLESLEW CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-8035
Mailing Address - Country:US
Mailing Address - Phone:989-400-3484
Mailing Address - Fax:
Practice Address - Street 1:2926 SEATTLESLEW CT
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-8035
Practice Address - Country:US
Practice Address - Phone:989-400-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2023-02-21
Deactivation Date:2012-12-18
Deactivation Code:
Reactivation Date:2023-02-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist