Provider Demographics
NPI:1194887968
Name:BECKMANN, ESTHER (PHD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:BECKMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4149 HOLLAND SYLVANIA RD
Mailing Address - Street 2:STE 8
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4808
Mailing Address - Country:US
Mailing Address - Phone:419-824-4555
Mailing Address - Fax:
Practice Address - Street 1:4149 HOLLAND SYLVANIA RD
Practice Address - Street 2:STE 8
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4808
Practice Address - Country:US
Practice Address - Phone:419-824-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2635103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0462459Medicaid
OH0462459Medicaid