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NPI Code Detail

MEDICARE: MICHELLE WANSTREET MT-BC, RBT, NMT

MEDICARE:   MICHELLE  WANSTREET  MT-BC, RBT, 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
1106S00000XBehavior TechnicianRBT-15-03563
2225A00000XMusic Therapist
3225A00000XMusic Therapist11807

General Provider Information

NPI Number : 1912540394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE WANSTREET MT-BC, RBT, NMT
Provider Business Mailing Address
First Line : 4759 REINHARDT DR
Second Line :
City : ROELAND PARK
State : KS
Zip : 66205-1504
Country : US
Telephone Number : 314-606-5248
Fax Number :
Provider Business Practice Location Address
First Line : 315 E 5TH ST STE 202
Second Line :
City : WATERLOO
State : IA
Zip : 50703-4757
Country : US
Telephone Number : 563-248-5781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2019
Last Update Date : 09/14/2021

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Directions to “ MICHELLE WANSTREET MT-BC, RBT, NMT” Practice Location

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