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General NPI Number Information
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NPI Number | 1700916525
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Entity Type | Individual
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Provider Name | AMY BECKER-MATTES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 601 EWING ST SUITE A-12
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City | PRINCETON
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State | NJ
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Zip | 08540-2757
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Country | US
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Telephone | 609-921-9299
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Fax | 609-921-1332
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Provider Business Mailing Address
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Address Line | 208 EDGERSTOUNE RD
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City | PRINCETON
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State | NJ
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Zip | 08540-6718
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Country | US
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Telephone | 609-924-5591
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Fax | 609-921-1332
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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 | NJ1934
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License Number State | NJ
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