Healthcare Provider Details
I. General information
NPI: 1689144305
Provider Name (Legal Business Name): TIMOHTY MICHAEL MCALEE II MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018
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
4305 N 9TH AVE
PHOENIX AZ
85013-2801
US
V. Phone/Fax
- Phone: 480-965-1082
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: