Healthcare Provider Details

I. General information

NPI: 1730974734
Provider Name (Legal Business Name): JUDITH ANN PINKERTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 E DIANA CT
POST FALLS ID
83854-7478
US

IV. Provider business mailing address

8465 W SAHARA AVE STE 111244
LAS VEGAS NV
89117-8960
US

V. Phone/Fax

Practice location:
  • Phone: 702-889-2881
  • Fax:
Mailing address:
  • Phone: 702-889-2881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number38972-LMT-3
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: