Provider Demographics
NPI:1295980613
Name:BECKER, MARI C (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:C
Last Name:BECKER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 S CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:12850-1117
Mailing Address - Country:US
Mailing Address - Phone:518-209-6711
Mailing Address - Fax:518-761-2035
Practice Address - Street 1:4122 S CREEK RD
Practice Address - Street 2:
Practice Address - City:MIDDLE GROVE
Practice Address - State:NY
Practice Address - Zip Code:12850-1117
Practice Address - Country:US
Practice Address - Phone:518-209-6711
Practice Address - Fax:518-761-2035
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001601-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist