MEDICARE: SADIE EITEMILLER 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	:	1619547890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADIE EITEMILLER MT-BC

Provider Business Mailing Address
First Line	:	1319 WOOTEN RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 N CIRCLE DR STE 400
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1184
Country	:	US
Telephone Number	:	719-331-6653
Fax Number	:

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

Provider Enumeration Date	:	06/29/2021
Last Update Date	:	06/01/2026

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Directions to “ SADIE EITEMILLER MT-BC” Practice Location

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