Provider Demographics
NPI:1659501856
Name:HYDE-BEGANY, DEE LORIS (BS, LCMT)
Entity Type:Individual
Prefix:MS
First Name:DEE
Middle Name:LORIS
Last Name:HYDE-BEGANY
Suffix:
Gender:F
Credentials:BS, LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-1728
Mailing Address - Country:US
Mailing Address - Phone:575-894-9731
Mailing Address - Fax:
Practice Address - Street 1:704 GRAPE ST
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1728
Practice Address - Country:US
Practice Address - Phone:575-894-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3747225700000X
HIMAT 10594225700000X
NMRMTI S-0306225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist