Provider Demographics
NPI:1578961074
Name:MORSE, AUDREY VANISKY (MA, MT-BC, LCAT)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:VANISKY
Last Name:MORSE
Suffix:
Gender:F
Credentials:MA, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 W 57TH ST APT 2K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1723
Mailing Address - Country:US
Mailing Address - Phone:212-300-3134
Mailing Address - Fax:
Practice Address - Street 1:435 W 57TH ST APT 2K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1723
Practice Address - Country:US
Practice Address - Phone:212-300-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001232-1225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist