Provider Demographics
NPI:1073022125
Name:BECHER, CLOE (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:CLOE
Middle Name:
Last Name:BECHER
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 2ND AVE NE UNIT 12
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-2007
Mailing Address - Country:US
Mailing Address - Phone:715-308-9984
Mailing Address - Fax:
Practice Address - Street 1:512 OAK AVE STE E
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-5703
Practice Address - Country:US
Practice Address - Phone:715-308-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22537225700000X
WI15161-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist