Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00588900 | NJ |
N | 225X00000X | Occupational Therapist | TOC101575 | PA |
NPI | 1003067596 |
---|---|
Provider Name | Ms. Amanda Elizabeth Beck |
First Address | Phillipsburg, NJ 08865-2230 |
Second Address | Easton, PA 18045-5540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2008 |
Last Update Date | 10/10/2014 |