Provider Demographics
NPI:1174962476
Name:SIEKIERSKI, BECKY (PHD, LSSP, NCSP)
Entity type:Individual
Prefix:DR
First Name:BECKY
Middle Name:
Last Name:SIEKIERSKI
Suffix:
Gender:F
Credentials:PHD, LSSP, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 ROYAL CREST DR STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2534
Mailing Address - Country:US
Mailing Address - Phone:281-407-5658
Mailing Address - Fax:281-407-5631
Practice Address - Street 1:16815 ROYAL CREST DR
Practice Address - Street 2:SUITE 160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2521
Practice Address - Country:US
Practice Address - Phone:281-407-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33696103TC2200X
TX31848103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool