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General NPI Number Information
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NPI Number | 1497884498
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Entity Type | Individual
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Provider Name | NICOLE BECKER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 2647 KIMBERLY RD STE 2
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City | TWIN FALLS
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State | ID
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Zip | 83301-7976
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Country | US
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Telephone | 208-734-1281
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Fax | 208-933-4435
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Provider Business Mailing Address
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Address Line | 794 EASTLAND DR
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City | TWIN FALLS
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State | ID
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Zip | 83301-6856
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Country | US
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Telephone | 208-734-3312
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Fax | 208-933-4435
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7671932
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY26010
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 26010
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License Number State | CA
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