Provider Demographics
NPI:1437357340
Name:BECKER, RITAANN T (LMT)
Entity Type:Individual
Prefix:MS
First Name:RITAANN
Middle Name:T
Last Name:BECKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 SHADY REST RD
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-4642
Mailing Address - Country:US
Mailing Address - Phone:850-539-8517
Mailing Address - Fax:
Practice Address - Street 1:889 SHADY REST RD
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:FL
Practice Address - Zip Code:32333-4642
Practice Address - Country:US
Practice Address - Phone:850-539-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA7036225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist