MEDICARE: MS. CORINNE MARIE-WOOLLEY RICHARDS MA, 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	09686

General Provider Information

NPI Number	:	1982073276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CORINNE MARIE-WOOLLEY RICHARDS MA, MT-BC

Provider Business Mailing Address
First Line	:	10933 CHIPPENDALE AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79934-3133
Country	:	US
Telephone Number	:	610-393-1610
Fax Number	:

Provider Business Practice Location Address
First Line	:	10933 CHIPPENDALE AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79934-3133
Country	:	US
Telephone Number	:	610-393-1610
Fax Number	:

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

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	09/17/2015

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