Individual
DR. MARY GAIL BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH. D.
Contact information
Practice address
4685 BASELINE RD, BOULDER, CO 80303-2601
(303) 494-0535
Mailing address
4860 ROBB ST, SUITE 201, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS006056L
PA
103TC0700X
Clinical Psychologist
Primary
PSY.0003825
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY.0003825
PROFESSIONAL LICENSE
CO
Enumeration date
05/18/2007
Last updated
10/02/2013
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