Provider Demographics
NPI:1326557760
Name:BECKER, HANNAH ROSEMARY (DOM)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:ROSEMARY
Last Name:BECKER
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 GUSDORF RD STE O
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6298
Mailing Address - Country:US
Mailing Address - Phone:575-776-7806
Mailing Address - Fax:
Practice Address - Street 1:1337 GUSDORF RD STE O
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6298
Practice Address - Country:US
Practice Address - Phone:575-776-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist