Individual
STACIE JO BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS. CCC-SLP
Contact information
Practice address
3171 S BOWN WAY, BOISE, ID 83706-5665
(208) 433-9152
Mailing address
3171 S BOWN WAY, BOISE, ID 83706-5665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1683
ID
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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