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General NPI Number Information
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NPI Number | 1922620715
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Entity Type | Individual
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Provider Name | TATUM M KLINE MT-BC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 7108 1ST AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-3105
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Country | US
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Telephone | 715-553-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 7108 1ST AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-3105
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Country | US
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Telephone | 612-424-0342
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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 | 203-38
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License Number State | WI
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Taxonomy #2
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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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