Provider Demographics
NPI:1154644953
Name:CLEVELAND, JOHN JAY (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JAY
Last Name:CLEVELAND
Suffix:
Gender:M
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 1:1047 E GENEVA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3804
Mailing Address - Country:US
Mailing Address - Phone:602-819-7431
Mailing Address - Fax:480-784-2297
Practice Address - Street 1:1047 E GENEVA DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3804
Practice Address - Country:US
Practice Address - Phone:602-819-7431
Practice Address - Fax:480-784-2297
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist