Healthcare Provider Details

I. General information

NPI: 1730012352
Provider Name (Legal Business Name): MALEA BECKER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MONROE AVE S
HOPKINS MN
55343-8405
US

IV. Provider business mailing address

1269 POND CURV
WACONIA MN
55387-3110
US

V. Phone/Fax

Practice location:
  • Phone: 952-988-5000
  • Fax:
Mailing address:
  • Phone: 952-807-4915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number105213
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: