Provider Demographics
NPI:1992858187
Name:BECKUM, KELI LANIER (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KELI
Middle Name:LANIER
Last Name:BECKUM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S TEAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-8419
Mailing Address - Country:US
Mailing Address - Phone:912-280-0223
Mailing Address - Fax:
Practice Address - Street 1:238 S TEAKWOOD CT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-8419
Practice Address - Country:US
Practice Address - Phone:912-280-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003221225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist