| Doctor Name: | DR. JACKY BECK |
| NPI Number: | 1043456981 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | |
| Business Practice Address: | 1511a Rainbow Dr Gadsden, AL - 359015370 |
| Business Phone Number: | 2565438880 |
| Business Fax Number: | 2565438889 |
| Mailing Address: | 1511a Rainbow Dr, GADSDEN |
| State: | AL |
| Postal Code: | 359015370 |
| Phone Number: | 2565438880 |
| Fax Number: | 2565438889 |
| NPI Enumeration Date: | 12/24/2008 |
| NPI Last Update Date: | 12/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |