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General NPI Number Information
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NPI Number | 1700200177
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Entity Type | Individual
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Provider Name | EMILY SUTIN MT-BC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 10 UNION ST
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City | MEDFORD
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State | NJ
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Zip | 08055-2416
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Country | US
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Telephone | 609-654-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 3104 FANSHAWE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2608
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Country | US
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Telephone | 267-391-6461
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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 | 08592
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License Number State | PA
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