Raquel V Martin Becerra

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012726 Issued in GA

Practice address

1949 Highway 81 Ste 100
Loganville, GA 30052-4583

Phone

(770) 207-6390

NPI assigned

Nov 27, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Activekidz & Adult Therapy Services

  • Physical Therapist
  • Loganville, GA
  • NPI 1881825057
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1700652252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 HIGHWAY 81 STE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524583",
            "telephone_number": "770-207-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 HIGHWAY 81 STE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524583",
            "telephone_number": "770-207-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN BECERRA",
        "first_name": "RAQUEL",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajeive Antwan Manradgh, LAPC, NCC
• Ashley Marchelle Manuel
• Robert David Maresca, DPT
• Marion'S Personal Care Home
• Katherine Martell, PT
• Aquesha Martin, MS, OTR/L
• Caitlin Culver Martin
• Jennifer Mask
• Carey Campbell Mathurin
• Matrix Rehabilitation - Georgia, Inc.

• Speech-Language Pathologist in Loganville, GA
• Providers in Loganville, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.