Individual
CARLY BECKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 986-4985
Mailing address
2599 TRAVELERS WAY, JACKSON, MO 63755-2480
(661) 733-8457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2020038457
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2015
Last updated
07/12/2021
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