MEDICARE: MRS. KRISTEN LYN CROUCH MED, MM, MT-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1558688911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTEN LYN CROUCH MED, MM, MT-BC

Provider Business Mailing Address
First Line	:	410 AMADOR LN
Second Line	:	UNIT 2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-8344
Country	:	US
Telephone Number	:	561-758-2326
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 AMADOR LN
Second Line	:	UNIT 2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-8344
Country	:	US
Telephone Number	:	561-758-2326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2010
Last Update Date	:	06/21/2012

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