Provider Demographics
NPI:1700916525
Name:BECKER-MATTES, AMY (PHD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BECKER-MATTES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 EDGERSTOUNE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6718
Mailing Address - Country:US
Mailing Address - Phone:609-924-5591
Mailing Address - Fax:609-921-1332
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE A-12
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-921-9299
Practice Address - Fax:609-921-1332
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ1934103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist