1821830886 NPI number — ARBOR PSYCHOLOGY GROUP ASSOCIATES PLLC

Table of content: VANESSIA TALEISHA MARIE BECKER (NPI 1598338162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821830886 NPI number — ARBOR PSYCHOLOGY GROUP ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARBOR PSYCHOLOGY GROUP ASSOCIATES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821830886
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3055 PLYMOUTH RD STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48105-3208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-997-5033
Provider Business Mailing Address Fax Number:
844-855-5210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3055 PLYMOUTH RD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48105-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-997-5033
Provider Business Practice Location Address Fax Number:
844-855-5210
Provider Enumeration Date:
06/11/2024

Additional Information

Authorized Official

Authorized Official Last Name:
PEARSON
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL PSYCHOLOGIST/DIRECTOR
Authorized Official Telephone Number:
216-798-2837

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com