Provider Demographics
NPI:1992829808
Name:BECKLER, NEYSA MAE
Entity Type:Individual
Prefix:
First Name:NEYSA
Middle Name:MAE
Last Name:BECKLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NEYSA
Other - Middle Name:MAE
Other - Last Name:BECKLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2057 FRANKLIN LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-8521
Mailing Address - Country:US
Mailing Address - Phone:513-231-4561
Mailing Address - Fax:
Practice Address - Street 1:6900 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2910
Practice Address - Country:US
Practice Address - Phone:513-231-4561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0714224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant