Provider Demographics
NPI:1801166228
Name:BECK, CHANDEL MARIE (SLPA)
Entity type:Individual
Prefix:MRS
First Name:CHANDEL
Middle Name:MARIE
Last Name:BECK
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 N PARK DR # A
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3927
Mailing Address - Country:US
Mailing Address - Phone:928-221-2913
Mailing Address - Fax:
Practice Address - Street 1:1805 W HEAVENLY CT
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2836
Practice Address - Country:US
Practice Address - Phone:928-226-1563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA75382355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant