Provider Demographics
NPI:1851981948
Name:MEADOWS, MICHELLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MEADOWS
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 1:3121 COLFAX AVE S APT 2B
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2842
Mailing Address - Country:US
Mailing Address - Phone:563-271-8139
Mailing Address - Fax:
Practice Address - Street 1:3121 COLFAX AVE S APT 2B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2842
Practice Address - Country:US
Practice Address - Phone:563-271-8139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist