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General NPI Number Information
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NPI Number | 1497921332
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Entity Type | Organization
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Legal Business Name | MILTON E. BECKNELL, PH.D., LLC.
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 7244 FAR HILLS AVE
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City | CENTERVILLE
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State | OH
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Zip | 45459-4207
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Country | US
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Telephone | 937-684-2035
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Fax | 937-395-1311
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Provider Business Mailing Address
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Address Line | 7244 FAR HILLS AVE
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City | CENTERVILLE
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State | OH
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Zip | 45459-4207
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Country | US
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Telephone | 937-684-2035
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Fax | 937-395-1311
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MILTON EDWARD BECKNELL
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Credential | PH.D.
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Telephone | 937-684-2035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5682
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License Number State | OH
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