Provider Demographics
NPI:1790377182
Name:BECK, JULIANNE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 SUMMIT TRAIL CIR APT A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4847
Mailing Address - Country:US
Mailing Address - Phone:561-445-4830
Mailing Address - Fax:
Practice Address - Street 1:1057 SUMMIT TRAIL CIR APT A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4847
Practice Address - Country:US
Practice Address - Phone:561-445-4830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA89695225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA89695OtherMASSAGE THERAPIST LICENSE