MEDICARE: MS. ANDREA ELIZABETH CARRANZA MT-BC, PT AIDE

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	06994	CA

General Provider Information

NPI Number	:	1336433465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA ELIZABETH CARRANZA MT-BC, PT AIDE

Provider Business Mailing Address
First Line	:	4820 CAROLINE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5608
Country	:	US
Telephone Number	:	713-298-1934
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 CAROLINE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5608
Country	:	US
Telephone Number	:	713-298-1934
Fax Number	:

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

Provider Enumeration Date	:	06/06/2011
Last Update Date	:	06/06/2011

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