Provider Demographics
NPI:1538633193
Name:BECKER, JANICE L (LMT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:BECKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 HERBERICH AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-1531
Mailing Address - Country:US
Mailing Address - Phone:330-671-7462
Mailing Address - Fax:866-848-8617
Practice Address - Street 1:2717 S ARLINGTON RD STE A
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4725
Practice Address - Country:US
Practice Address - Phone:330-671-7461
Practice Address - Fax:866-848-8617
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5316225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist