Provider Demographics
NPI:1508477506
Name:EMANUELE, MAURIZIO (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:MAURIZIO
Middle Name:
Last Name:EMANUELE
Suffix:
Gender:M
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 1:836 N UNION CITY RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9228
Mailing Address - Country:US
Mailing Address - Phone:734-363-5672
Mailing Address - Fax:
Practice Address - Street 1:836 N UNION CITY RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9228
Practice Address - Country:US
Practice Address - Phone:734-363-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist