Provider Demographics
NPI:1245425784
Name:BECK, TERRI SUE (PT)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:SUE
Last Name:BECK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 SHEPPARD LN.
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-531-2406
Mailing Address - Fax:410-766-4668
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:STE. 400
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5884
Practice Address - Country:US
Practice Address - Phone:410-760-0093
Practice Address - Fax:410-766-4668
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16302174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist