Provider Demographics
NPI:1932684511
Name:OULTON, ERIN (MT-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:OULTON
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 1:3307 SHADY AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-3012
Mailing Address - Country:US
Mailing Address - Phone:412-432-9559
Mailing Address - Fax:
Practice Address - Street 1:3307 SHADY AVENUE EXT
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-3012
Practice Address - Country:US
Practice Address - Phone:412-432-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13947225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13760332060OtherFINE ART MIRACLES INC