MEDICARE: MRS. KRISTIN HOOD WRIGHT 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

General Provider Information

NPI Number	:	1649830118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN HOOD WRIGHT MT-BC

Provider Business Mailing Address
First Line	:	3724 SHADY GROVE RD
Second Line	:
City	:	PROVIDENCE
State	:	NC
Zip	:	27315-9312
Country	:	US
Telephone Number	:	434-709-5872
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 MAPLE AVE SW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24016-4707
Country	:	US
Telephone Number	:	434-709-5872
Fax Number	:

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

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	06/17/2019

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