Miranda May Eden, MT-BC
Individual provider Active NPI Music Therapist · Lowell, MI
NPI 1144530551 · NPPES record last updated Oct 19, 2010
Key facts
- NPI
- 1144530551
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Music Therapist 225A00000X
- License
- 225A00000X (MI)
- Practice address
- 11650 Downes St NE
Lowell, MI 49331-9489 - Phone
- (616) 897-7842
- Fax
- (616) 897-7054
- NPI assigned
- Oct 19, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225A00000X | MI | MD | Music Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 225A00000X | MI | Yes |
Addresses
Primary practice location
11650 Downes St NE
Lowell, MI 49331-9489
Mailing address
11650 Downes St NE
Lowell, MI 49331-9489
Phone (616) 897-7842
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05865 | Other | MI | CBMT IDENTIFICATION |
Other providers in Lowell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.