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NPI Code Detail

MEDICARE: MRS. DEBRA AILEEN BECKSTETT LISW-S

MEDICARE: MRS. DEBRA AILEEN BECKSTETT LISW-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI 0005072OH

General Provider Information

NPI Number : 1376515486
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA AILEEN BECKSTETT LISW-S
Provider Business Mailing Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9029
Fax Number :
Provider Business Practice Location Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-5106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 04/18/2017

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