Provider Demographics
NPI:1073068193
Name:BECKER, RYAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20720 WATERTOWN RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1823
Mailing Address - Country:US
Mailing Address - Phone:262-717-9000
Mailing Address - Fax:262-717-9970
Practice Address - Street 1:20720 WATERTOWN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1823
Practice Address - Country:US
Practice Address - Phone:262-717-9000
Practice Address - Fax:262-717-9970
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist