Provider Demographics
NPI:1790003390
Name:BECKWITH, ERIN RAE (MED, ATC, LAT, CSCS)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RAE
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:MED, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CALHOUN ST APT 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1566
Mailing Address - Country:US
Mailing Address - Phone:330-421-5597
Mailing Address - Fax:
Practice Address - Street 1:5701 DELHI RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-1669
Practice Address - Country:US
Practice Address - Phone:513-244-4875
Practice Address - Fax:513-244-4372
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
OH0022052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer