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NPI Code Detail

MEDICARE: BETHANY ERIKSEN MT-BC, NMT

MEDICARE: BETHANY ERIKSEN MT-BC, NMT
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 : 1306073077
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY ERIKSEN MT-BC, NMT
Provider Business Mailing Address
First Line : 2702 N 3RD ST STE 1000
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-4605
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2702 N 3RD ST STE 1000
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-4605
Country : US
Telephone Number : 602-840-6410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2009
Last Update Date : 06/19/2009

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Directions to “ BETHANY ERIKSEN MT-BC, NMT” Practice Location

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