Healthcare Provider Details

I. General information

NPI: 1033929344
Provider Name (Legal Business Name): CAITLYN BODINE MM, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 HOWARD ST
KALAMAZOO MI
49008-1919
US

IV. Provider business mailing address

605 HOWARD ST
KALAMAZOO MI
49008-1919
US

V. Phone/Fax

Practice location:
  • Phone: 269-220-0641
  • Fax:
Mailing address:
  • Phone: 269-220-0641
  • 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: