Provider Demographics
NPI:1518229335
Name:BECCARIA, STACIE (MS SPED)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:BECCARIA
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:TUPPER LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12986-1028
Mailing Address - Country:US
Mailing Address - Phone:518-359-7518
Mailing Address - Fax:
Practice Address - Street 1:12 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:TUPPER LAKE
Practice Address - State:NY
Practice Address - Zip Code:12986-1028
Practice Address - Country:US
Practice Address - Phone:518-359-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist