Provider Demographics
NPI:1033557624
Name:NAKAMURA, NORIKO (MT-BC)
Entity Type:Individual
Prefix:
First Name:NORIKO
Middle Name:
Last Name:NAKAMURA
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15208 W 123RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1081
Mailing Address - Country:US
Mailing Address - Phone:913-744-1265
Mailing Address - Fax:
Practice Address - Street 1:15208 W 123RD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1081
Practice Address - Country:US
Practice Address - Phone:913-744-1265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
07062OtherCERTIFICATION BOARD FOR MUSIC THERAPISTS