Healthcare Provider Details

I. General information

NPI: 1659501856
Provider Name (Legal Business Name): DEE LORIS HYDE-BEGANY B.S., LCMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 GRAPE ST
TRUTH OR CONSEQUENCES NM
87901-1728
US

IV. Provider business mailing address

704 GRAPE ST
TRUTH OR CONSEQUENCES NM
87901-1728
US

V. Phone/Fax

Practice location:
  • Phone: 575-894-9731
  • Fax:
Mailing address:
  • Phone: 575-894-9731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3747
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT 10594
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberRMTI S-0306
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: