Individual
EMILY BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 JOHNSON FY RD NE STE 410, ATLANTA, GA 30342-1709
(404) 847-0664
Mailing address
1100 JOHNSON FY RD NE STE 410, ATLANTA, GA 30342-1709
(404) 847-0664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12405
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12405
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
05/22/2024
Last updated
07/22/2024
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