Provider Demographics
NPI:1477085199
Name:PHILIPPE, ANNA (MT-BC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PHILIPPE
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 1:4934 E NISBET RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2266
Mailing Address - Country:US
Mailing Address - Phone:602-402-0122
Mailing Address - Fax:
Practice Address - Street 1:4934 E NISBET RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2266
Practice Address - Country:US
Practice Address - Phone:602-402-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12919225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist