Healthcare Provider Details
I. General information
NPI: 1881042455
Provider Name (Legal Business Name): EMILY NEWCOMER MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2016
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
431 NW 100TH PL APT 303
SEATTLE WA
98177-4953
US
IV. Provider business mailing address
431 NW 100TH PL APT 303
SEATTLE WA
98177-4953
US
V. Phone/Fax
- Phone: 724-600-4953
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: