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General NPI Number Information
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NPI Number | 1174962476
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Entity Type | Individual
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Provider Name | BECKY SIEKIERSKI PHD, LSSP, NCSP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 16815 ROYAL CREST DR SUITE 160
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City | HOUSTON
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State | TX
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Zip | 77058-2521
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Country | US
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Telephone | 281-407-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 16815 ROYAL CREST DR STE 160
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City | HOUSTON
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State | TX
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Zip | 77058-2534
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Country | US
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Telephone | 281-407-5658
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Fax | 281-407-5631
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 33696
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 31848
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License Number State | TX
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