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NPI 1689696619

NPI 1689696619 : SALLY A. BECK LSCSW : WICHITA, KS

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General NPI Number Information
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    NPI Number           |    1689696619
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    Entity Type          |    Individual 
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    Provider Name        |    SALLY A. BECK LSCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/25/2006
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    Last Update Date     |    12/03/2013
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Provider Practice Location Address
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    Address Line         |    437 N TOPEKA ST 
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    City                 |    WICHITA
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    State                |    KS
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    Zip                  |    67202-2413
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    Country              |    US
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    Telephone            |    316-264-8344
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    Fax                  |    316-263-5259
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Provider Business Mailing Address
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    Address Line         |    437 N TOPEKA ST 
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    City                 |    WICHITA
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    State                |    KS
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    Zip                  |    67202-2413
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    Country              |    US
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    Telephone            |    316-264-8344
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    Fax                  |    316-263-5259
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    3592
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    License Number State |    KS
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