Healthcare Provider Details

I. General information

NPI: 1831320464
Provider Name (Legal Business Name): NANCY I PERRY MT-BC, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 COLEBROOK DR
ROCHESTER NY
14617-2211
US

IV. Provider business mailing address

PO BOX 10476
ROCHESTER NY
14610-0476
US

V. Phone/Fax

Practice location:
  • Phone: 585-467-4567
  • Fax:
Mailing address:
  • Phone: 585-755-6165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number07870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: