Provider Demographics
NPI:1093035230
Name:MAHALEC, BECKY LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:MAHALEC
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 MARIAN LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-8610
Mailing Address - Country:US
Mailing Address - Phone:832-289-5118
Mailing Address - Fax:
Practice Address - Street 1:3219 MARIAN LN
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-8610
Practice Address - Country:US
Practice Address - Phone:832-289-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2011-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist