Healthcare Provider Details

I. General information

NPI: 1134978539
Provider Name (Legal Business Name): ISABELLA RAE GILTNER MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 PALM DR APT D4
SATELLITE BEACH FL
32937-2554
US

IV. Provider business mailing address

651 PALM DR APT D4
SATELLITE BEACH FL
32937-2554
US

V. Phone/Fax

Practice location:
  • Phone: 636-856-7626
  • Fax:
Mailing address:
  • Phone: 636-856-7626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number18087
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: