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General NPI Number Information
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NPI Number | 1154769263
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Entity Type | Individual
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Provider Name | TATYANA NATASHA MARTIN MT-BC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 1356 CAMBRIDGE BELTWAY
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City | CAMBRIDGE
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State | MD
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Zip | 21613-3033
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Country | US
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Telephone | 412-216-6368
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Fax |
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Provider Business Mailing Address
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Address Line | 1356 CAMBRIDGE BELTWAY
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City | CAMBRIDGE
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State | MD
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Zip | 21613-3033
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Country | US
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Telephone | 412-216-6368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 10729
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License Number State | PA
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