Doctor Name: | KATHERINE BECKETT |
NPI Number: | 1043602576 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6801094094 |
Business Practice Address: | 255 Colrain St Sw Suite 2 Wyoming, MI - 495481048 |
Business Phone Number: | 6169881479 |
Business Fax Number: | |
Mailing Address: | 1939 Division Ave S, GRAND RAPIDS |
State: | MI |
Postal Code: | 495072459 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/20/2015 |
NPI Last Update Date: | 02/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801094094 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |