Provider Demographics
NPI:1740530468
Name:BECKER, TONYA N (PT, DPT)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:N
Last Name:BECKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:N
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:#110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6710
Mailing Address - Country:US
Mailing Address - Phone:480-860-4298
Mailing Address - Fax:480-860-0356
Practice Address - Street 1:4418 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-3316
Practice Address - Country:US
Practice Address - Phone:314-894-2222
Practice Address - Fax:314-894-2223
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9958225100000X
MO2016042621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist