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General NPI Number Information
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NPI Number | 1093950263
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Entity Type | Organization
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Legal Business Name | BECKY STIDHAM & ASSOCIATES
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 6750 WEST LOOP S STE 710
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City | BELLAIRE
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State | TX
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Zip | 77401-4103
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Country | US
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Telephone | 713-666-0710
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Fax | 713-666-0711
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Provider Business Mailing Address
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Address Line | 6750 WEST LOOP S STE 710
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City | BELLAIRE
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State | TX
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Zip | 77401-4103
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Country | US
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Telephone | 713-666-0710
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Fax | 713-666-0711
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Authorized Official
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Title or Position | CEO
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Name | REBECCA CLAIR STIDHAM
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Credential | LCSW
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Telephone | 713-666-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 33550
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License Number State | TX
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