Healthcare Provider Details

I. General information

NPI: 1699261354
Provider Name (Legal Business Name): JOCELYN KHOO MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 SAINT GEORGE ST
DUXBURY MA
02332-3812
US

IV. Provider business mailing address

14 MAGNOLIA ST APT 3
ARLINGTON MA
02474-8728
US

V. Phone/Fax

Practice location:
  • Phone: 781-934-2731
  • Fax:
Mailing address:
  • Phone: 617-470-1468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number13311
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: