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NPI Code Detail

MEDICARE: KATIE SMITH MT-BC

MEDICARE: KATIE SMITH MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225A00000XMusic Therapist

General Provider Information

NPI Number : 1144965526
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE SMITH MT-BC
Provider Business Mailing Address
First Line : 6620 ANGELLO CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-1773
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6620 ANGELLO CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-1773
Country : US
Telephone Number : 260-245-3593
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2022
Last Update Date : 02/08/2024

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Directions to “ KATIE SMITH MT-BC” Practice Location

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