Provider Demographics
NPI:1598056145
Name:BECKHAM, HEATHER ANN (CMT, PARAMEDIC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:CMT, PARAMEDIC
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PARAMEDIC
Mailing Address - Street 1:PO BOX 6424
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604
Mailing Address - Country:US
Mailing Address - Phone:406-227-5653
Mailing Address - Fax:
Practice Address - Street 1:425 NORTH LAST CHANGE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-227-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT216225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist