Provider Demographics
NPI:1831986553
Name:SWAN, BECCA (MT MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BECCA
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:MT MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 HATCHET MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:ME
Mailing Address - Zip Code:04847-3314
Mailing Address - Country:US
Mailing Address - Phone:207-542-2062
Mailing Address - Fax:
Practice Address - Street 1:445 HATCHET MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:ME
Practice Address - Zip Code:04847-3314
Practice Address - Country:US
Practice Address - Phone:207-542-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT330225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist