Healthcare Provider Details

I. General information

NPI: 1811293335
Provider Name (Legal Business Name): MELINDA ANNE HUMMEL MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 S DONINGTON CT
BLOOMINGTON IN
47401-8840
US

IV. Provider business mailing address

1214 S DONINGTON CT
BLOOMINGTON IN
47401-8840
US

V. Phone/Fax

Practice location:
  • Phone: 812-449-9776
  • Fax:
Mailing address:
  • Phone: 812-449-9776
  • 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: