Provider Demographics
NPI:1528712049
Name:TEJRAL BECKER, DANIELLE DOROTHY (MSW, CSW-PIP, QMHP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:DOROTHY
Last Name:TEJRAL BECKER
Suffix:
Gender:F
Credentials:MSW, CSW-PIP, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46677 CANARY PL
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-8036
Mailing Address - Country:US
Mailing Address - Phone:402-290-5742
Mailing Address - Fax:
Practice Address - Street 1:46677 CANARY PL
Practice Address - Street 2:
Practice Address - City:TEA
Practice Address - State:SD
Practice Address - Zip Code:57064-8036
Practice Address - Country:US
Practice Address - Phone:402-290-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD52201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical