Healthcare Provider Details

I. General information

NPI: 1184159659
Provider Name (Legal Business Name): EMILIE DUPUIS MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CURRY RD
TEMPE AZ
85281-2009
US

IV. Provider business mailing address

PO BOX 7608
TEMPE AZ
85281-0021
US

V. Phone/Fax

Practice location:
  • Phone: 480-965-1082
  • Fax:
Mailing address:
  • Phone: 602-653-1046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: