Healthcare Provider Details

I. General information

NPI: 1427698703
Provider Name (Legal Business Name): CHRISTOPHER ROBERT MILLETT MM, MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ATTN: CHRIS MILLETT - MUSIC THERAPY CLINIC, SCHOOL OF M 2301 SOUTH 3RD ST
LOUISVILLE KY
40292
US

IV. Provider business mailing address

ATTN: CHRIS MILLETT - MUSIC THERAPY CLINIC, SCHOOL OF M 2301 SOUTH 3RD ST
LOUISVILLE KY
40292
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-2122
  • Fax:
Mailing address:
  • Phone: 502-852-2122
  • 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: