Provider Demographics
NPI:1942976451
Name:BECKER, AMY (AUD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 FOX MEADOWS BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6928
Mailing Address - Country:US
Mailing Address - Phone:865-453-3892
Mailing Address - Fax:
Practice Address - Street 1:1240 FOX MEADOWS BLVD STE 5
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6928
Practice Address - Country:US
Practice Address - Phone:869-453-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1991237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter