Provider Demographics
NPI:1447085436
Name:BECK, MARIELLA A
Entity type:Individual
Prefix:
First Name:MARIELLA
Middle Name:A
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B1 GARDEN CT # B1GA
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2449
Mailing Address - Country:US
Mailing Address - Phone:973-735-8792
Mailing Address - Fax:
Practice Address - Street 1:B1 GARDEN CT # B1GA
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2449
Practice Address - Country:US
Practice Address - Phone:973-735-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician