Healthcare Provider Details

I. General information

NPI: 1962730408
Provider Name (Legal Business Name): KIMBERLY KHARE MA, CMT, NRMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 WARREN AVE COMMUNITY MUSIC CENTER OF BOSTON
BOSTON MA
02116-6104
US

IV. Provider business mailing address

34 WARREN AVE COMMUNITY MUSIC CENTER OF BOSTON
BOSTON MA
02116-6104
US

V. Phone/Fax

Practice location:
  • Phone: 617-482-7494
  • Fax: 617-482-6267
Mailing address:
  • Phone: 617-482-7494
  • Fax: 617-482-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: