MEDICARE: MELINDA MARIE BARNES 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
1	225A00000X	Music Therapist	9480115-4010	UT

General Provider Information

NPI Number	:	1245734326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA MARIE BARNES MT-BC

Provider Business Mailing Address
First Line	:	3846 S 4025 W
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-9676
Country	:	US
Telephone Number	:	801-725-9297
Fax Number	:

Provider Business Practice Location Address
First Line	:	3846 S 4025 W
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-9676
Country	:	US
Telephone Number	:	801-725-9297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2018
Last Update Date	:	03/22/2018

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