Provider Demographics
NPI:1396398459
Name:NUNBERG, MORGAN (MT-BC/L)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:NUNBERG
Suffix:
Gender:F
Credentials:MT-BC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 S WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6772
Mailing Address - Country:US
Mailing Address - Phone:701-213-2004
Mailing Address - Fax:
Practice Address - Street 1:2512 S WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6772
Practice Address - Country:US
Practice Address - Phone:701-213-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2018-01225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
13920OtherTHE CERTIFICATION BOARD FOR MUSIC THERAPIST