MEDICARE: HEATHER NICOLE BELSHE 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	08938

General Provider Information

NPI Number	:	1720377054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER NICOLE BELSHE MT-BC

Provider Business Mailing Address
First Line	:	PO BOX 33913
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76162-3913
Country	:	US
Telephone Number	:	817-458-8813
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 EDEN AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76117-5625
Country	:	US
Telephone Number	:	817-458-8813
Fax Number	:

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

Provider Enumeration Date	:	04/07/2011
Last Update Date	:	02/11/2016

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