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General NPI Number Information
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NPI Number | 1689204638
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Entity Type | Individual
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Provider Name | MARCELA BECERRA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 38061 W LA PAZ ST
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City | MARICOPA
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State | AZ
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Zip | 85138-4187
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Country | US
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Telephone | 480-410-0174
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Fax |
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Provider Business Mailing Address
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Address Line | 994 S HARRISON RD
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City | TUCSON
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State | AZ
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Zip | 85748-6608
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Country | US
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Telephone | 520-721-1887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 9959519
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License Number State | AZ
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