Healthcare Provider Details

I. General information

NPI: 1780596692
Provider Name (Legal Business Name): MRS. ANA ARIADNE BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7742 SPALDING DR # 358
NORCROSS GA
30092-4207
US

IV. Provider business mailing address

3927 DAHLWINY CT
SANDY SPRINGS GA
30350-1153
US

V. Phone/Fax

Practice location:
  • Phone: 786-484-6883
  • Fax:
Mailing address:
  • Phone: 786-484-6883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: