Provider Demographics
NPI:1184045247
Name:BARBO, KRISTINA (MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:
Last Name:BARBO
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 1:26 W WYOMING AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-4652
Mailing Address - Country:US
Mailing Address - Phone:781-439-5597
Mailing Address - Fax:
Practice Address - Street 1:26 W WYOMING AVE
Practice Address - Street 2:APT 4C
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-4652
Practice Address - Country:US
Practice Address - Phone:781-439-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10351225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist