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General NPI Number Information
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NPI Number | 1518471176
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Entity Type | Individual
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Provider Name | CATHERINE BACKUS MT-BC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2017
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Last Update Date | 11/18/2017
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Provider Practice Location Address
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Address Line | 8231 WILLIAMSON RD
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City | ROANOKE
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State | VA
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Zip | 24019
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Country | US
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Telephone | 540-384-1679
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Fax |
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Provider Business Mailing Address
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Address Line | 610C BLUE RIDGE AVE
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City | BEDFORD
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State | VA
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Zip | 24523-2502
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Country | US
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Telephone |
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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 | 11700
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License Number State |
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