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General NPI Number Information
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NPI Number | 1801751763
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Entity Type | Individual
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Provider Name | BETHENEY LINN ELLCESSOR
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Gender | Female
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 1812 UNIVERSITY BLVD
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City | ANDERSON
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State | IN
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Zip | 46012-3101
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Country | US
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Telephone | 765-356-4934
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Fax |
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Provider Business Mailing Address
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Address Line | 13936 W MAIN ST
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City | DALEVILLE
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State | IN
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Zip | 47334-9662
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Country | US
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Telephone | 765-356-4934
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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 | IN
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