Provider Demographics
NPI:1962624338
Name:BECKER, JACQUELINE HOPE (PHD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:HOPE
Last Name:BECKER
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 1:307 E 44TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4400
Mailing Address - Country:US
Mailing Address - Phone:212-682-7600
Mailing Address - Fax:212-682-7600
Practice Address - Street 1:307 E 44TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4400
Practice Address - Country:US
Practice Address - Phone:212-682-7600
Practice Address - Fax:212-682-7600
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7706103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist