Provider Demographics
NPI:1649508052
Name:BECHARD, TAMMI JO (MAC, LAC, THM)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:JO
Last Name:BECHARD
Suffix:
Gender:F
Credentials:MAC, LAC, THM
Other - Prefix:
Other - First Name:TEAJ
Other - Middle Name:
Other - Last Name:BECHARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAC, LAC, THM
Mailing Address - Street 1:575 MAIN ST
Mailing Address - Street 2:SUITE 149
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4343
Mailing Address - Country:US
Mailing Address - Phone:443-691-3089
Mailing Address - Fax:
Practice Address - Street 1:575 MAIN ST
Practice Address - Street 2:SUITE 149
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4343
Practice Address - Country:US
Practice Address - Phone:443-691-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01547171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist