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General NPI Number Information
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NPI Number | 1780494377
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Entity Type | Individual
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Provider Name | LISA NOELLE BECKER MA
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 2362 COUNTRY RD
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City | SHILOH
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State | IL
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Zip | 62221-2570
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Country | US
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Telephone | 773-659-9207
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Fax |
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Provider Business Mailing Address
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Address Line | 215 COLLEGE AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-1631
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Country | US
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Telephone | 314-307-1597
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Fax |
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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