Provider Demographics
NPI:1841036894
Name:CONTOPULOS, VANESSA (MT-BC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:CONTOPULOS
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 1:35156 TWIN OAKS RD
Mailing Address - Street 2:
Mailing Address - City:JULIAN
Mailing Address - State:CA
Mailing Address - Zip Code:92036-9470
Mailing Address - Country:US
Mailing Address - Phone:619-787-7937
Mailing Address - Fax:
Practice Address - Street 1:35156 TWIN OAKS RD
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:CA
Practice Address - Zip Code:92036-9470
Practice Address - Country:US
Practice Address - Phone:619-787-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist