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General NPI Number Information
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NPI Number | 1679203780
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Entity Type | Individual
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Provider Name | MIKAILA VIERYA LPMT, MT-BC
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Gender | Female
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 2568A RIVA RD STE 103
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7445
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Country | US
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Telephone | 410-697-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 931 FOREST HILLS AVE
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1755
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Country | US
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Telephone | 540-454-3193
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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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