MEDICARE: MARIA MEEDS 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	:	1861953515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MEEDS MT-BC

Provider Business Mailing Address
First Line	:	3560 W SAN JOSE AVE APT 109
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-6686
Country	:	US
Telephone Number	:	651-354-3494
Fax Number	:

Provider Business Practice Location Address
First Line	:	3560 W SAN JOSE AVE APT 109
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-6686
Country	:	US
Telephone Number	:	651-354-3494
Fax Number	:

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

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	03/19/2020

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Directions to “ MARIA MEEDS MT-BC” Practice Location

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