MEDICARE: MAUREEN O'SHAUGHNESSY 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
1	225A00000X	Music Therapist		CA

General Provider Information

NPI Number	:	1831482256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN O'SHAUGHNESSY MT-BC, NMT

Provider Business Mailing Address
First Line	:	6526 FRIARS RD
Second Line	:	#108
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7840 MISSION CENTER CT
Second Line	:	SUITE 205
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1319
Country	:	US
Telephone Number	:	619-299-1411
Fax Number	:

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

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	05/18/2011

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