Provider Demographics
NPI:1265264014
Name:BILL, LAURA JOAN (MT-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JOAN
Last Name:BILL
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 1:67 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-3227
Mailing Address - Country:US
Mailing Address - Phone:973-747-9117
Mailing Address - Fax:
Practice Address - Street 1:145 VREELAND AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1761
Practice Address - Country:US
Practice Address - Phone:973-661-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist