Provider Demographics
NPI:1437580321
Name:BECKER, ANGELA G (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:G
Last Name:BECKER
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 ANDRE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5303
Mailing Address - Country:US
Mailing Address - Phone:410-375-8130
Mailing Address - Fax:
Practice Address - Street 1:1439 E FORT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5575
Practice Address - Country:US
Practice Address - Phone:443-500-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02121171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist