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Individual

CHRISTINA ELISE BECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4404 S FLORIDA AVE, LAKELAND, FL 33813-2169
(863) 709-8110
Mailing address
660 S CENTRAL AVE, BARTOW, FL 33830-4627
(863) 430-7539

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH17461
FL
101YM0800X
Mental Health Counselor
Primary
IMH18461
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IMH17461
REGISTERED LMHC INTERN
FL
Enumeration date
11/03/2018
Last updated
11/03/2018
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