Provider Demographics
NPI:1194899872
Name:BECKER, WENDY MARIE (LMT, LAC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:BECKER
Suffix:
Gender:F
Credentials:LMT, LAC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WENDY BECKER
Mailing Address - Street 1:3861 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-495-8515
Mailing Address - Fax:
Practice Address - Street 1:3861 NORTH 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:206-355-8069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-23859225700000X
WAAC60279045171100000X
AZLAC-001100171100000X
WAMA00009772225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist