Healthcare Provider Details

I. General information

NPI: 1285844621
Provider Name (Legal Business Name): DEBORAH ANN POPE MT-BC, CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7024 W 113TH ST
BLOOMINGTON MN
55438-2446
US

IV. Provider business mailing address

7024 W 113TH ST
BLOOMINGTON MN
55438-2446
US

V. Phone/Fax

Practice location:
  • Phone: 952-944-1049
  • Fax:
Mailing address:
  • Phone: 952-944-1049
  • 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: