Basic Information
| Provider Information | |||||||||
| NPI: | 1588079198 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORIKO NAKAMURA, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MUSICAL JOURNEY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15208 W 123RD ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137441265 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15208 W 123RD ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137441265 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2014 | ||||||||
| LastUpdateDate: | 06/23/2014 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | NAKAMURA | ||||||||
| AuthorizedOfficialFirstName: | NORIKO | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/MUSIC THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 9137441265 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MT-BC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225A00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist |
No ID Information.