Healthcare Provider Details

I. General information

NPI: 1043496698
Provider Name (Legal Business Name): KRISTYN D BEEMAN MTBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7728 GREEN HILL RD
HARRISBURG PA
17112-9746
US

IV. Provider business mailing address

7728 GREEN HILL RD
HARRISBURG PA
17112-9746
US

V. Phone/Fax

Practice location:
  • Phone: 717-514-8160
  • Fax: 717-737-7486
Mailing address:
  • Phone: 717-514-8160
  • Fax: 717-737-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number07265
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: