Provider Demographics
NPI:1932824547
Name:BECKER, GABRIEL AARON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:AARON
Last Name:BECKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:GABE
Other - Middle Name:AARON
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2625 BARLEY CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-6336
Mailing Address - Country:US
Mailing Address - Phone:636-346-9427
Mailing Address - Fax:
Practice Address - Street 1:2625 BARLEY CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-6336
Practice Address - Country:US
Practice Address - Phone:636-346-9427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010840103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical