Elizabeth Ann Wagner, BM, MT-BC

Primary specialty

Music TherapistTaxonomy code 225A00000X

License

07956

Practice address

839 W Hermosa Dr
Wickenburg, AZ 85390-1247

Phone

(928) 679-3246

NPI assigned

Jun 22, 2012

Last updated

Dec 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702684800000",
    "number": "1215290465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W HERMOSA DR",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901247",
            "telephone_number": "928-679-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W HERMOSA DR",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901247",
            "telephone_number": "928-679-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "BM, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2023-12-16",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": "07956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Music Therapist in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Music Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.