Provider Demographics
NPI:1376308817
Name:DRUHAN, KIERA LYNN (MT-BC, NMT)
Entity Type:Individual
Prefix:
First Name:KIERA
Middle Name:LYNN
Last Name:DRUHAN
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7944
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04112-7944
Mailing Address - Country:US
Mailing Address - Phone:781-629-9713
Mailing Address - Fax:
Practice Address - Street 1:44 MEADOW LN APT 2
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-1870
Practice Address - Country:US
Practice Address - Phone:781-629-9713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16471225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist