Provider Demographics
NPI:1437697992
Name:ISRAEL, AMY (MM, MT-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 N GILPIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2547
Mailing Address - Country:US
Mailing Address - Phone:218-341-7040
Mailing Address - Fax:
Practice Address - Street 1:1446 N GILPIN ST APT 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2547
Practice Address - Country:US
Practice Address - Phone:218-341-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12329225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist