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General NPI Number Information
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NPI Number | 1194994061
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Entity Type | Individual
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Provider Name | NOBUYUKI SHIRAISHI NMT MT-BC LCAT
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Gender | Male
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 400 W FOREST AVE APT 114
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City | COALINGA
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State | CA
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Zip | 93210-2566
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Country | US
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Telephone | 979-665-7420
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 471
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City | COALINGA
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State | CA
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Zip | 93210-0471
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Country | US
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Telephone | 559-935-3186
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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 |
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License Number State |
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