Provider Demographics
NPI:1861430670
Name:BECKER, CYNTHIA (ACT,DOM)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:ACT,DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251B UPPER SAN PEDRO
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532
Mailing Address - Country:US
Mailing Address - Phone:505-501-5026
Mailing Address - Fax:505-820-3327
Practice Address - Street 1:251 SAN PEDRO RD
Practice Address - Street 2:UNITL B
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-8240
Practice Address - Country:US
Practice Address - Phone:505-501-5026
Practice Address - Fax:505-820-3327
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM356171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist