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General NPI Number Information
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NPI Number | 1962794834
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Entity Type | Individual
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Provider Name | KATHLEEN MARIE ESBENSEN MT-BC
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Gender | Female
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 412 E EAGLE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-1635
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Country | US
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Telephone | 610-449-9669
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Fax | 610-449-5566
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Provider Business Mailing Address
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Address Line | 240 OLD MILL RD
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City | ROYERSFORD
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State | PA
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Zip | 19468-2703
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Country | US
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Telephone | 610-792-0778
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Fax | 610-449-5566
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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 | 09776
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License Number State | PA
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