Healthcare Provider Details

I. General information

NPI: 1831909480
Provider Name (Legal Business Name): NICORA L BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 RYLAND ST
RENO NV
89501-2214
US

IV. Provider business mailing address

8001 MILITARY RD APT 2806
RENO NV
89506-4589
US

V. Phone/Fax

Practice location:
  • Phone: 775-762-3294
  • Fax:
Mailing address:
  • Phone: 775-762-3294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: