Healthcare Provider Details

I. General information

NPI: 1053591768
Provider Name (Legal Business Name): MARLA H BECK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 S CEDAR CREST BLVD SUITE 115
ALLENTOWN PA
18103-6372
US

IV. Provider business mailing address

1259 S CEDAR CREST BLVD SUITE 115
ALLENTOWN PA
18103-6372
US

V. Phone/Fax

Practice location:
  • Phone: 610-821-9422
  • Fax: 610-820-6308
Mailing address:
  • Phone: 610-821-9422
  • Fax: 610-820-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW003617E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: