Individual
CHARLES BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
Mailing address
721 10TH ST S, MOORHEAD, MN 56560-3562
(563) 316-0328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
02/02/2024
Last updated
12/22/2024
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