Healthcare Provider Details

I. General information

NPI: 1790955854
Provider Name (Legal Business Name): RUTH MINDEN-KUSNITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 SELWYN ROAD
BELMONT MA
02478-3557
US

IV. Provider business mailing address

77 SELWYN ROAD
BELMONT MA
02478-3557
US

V. Phone/Fax

Practice location:
  • Phone: 617-484-1735
  • Fax:
Mailing address:
  • Phone:
  • 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: