Provider Demographics
NPI:1922582717
Name:MCDONALD, AMELIA LOUISE (MT-BC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:LOUISE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:LOUISE
Other - Last Name:SEIDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:3270 19TH ST NW STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2949
Mailing Address - Country:US
Mailing Address - Phone:319-389-2831
Mailing Address - Fax:
Practice Address - Street 1:3270 19TH ST NW STE 101
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2949
Practice Address - Country:US
Practice Address - Phone:319-389-2831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist