Provider Demographics
NPI:1043719156
Name:CARR, BETH BUEHNE (MT-BC)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:BUEHNE
Last Name:CARR
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 1:3114 DOMAIN CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-3343
Mailing Address - Country:US
Mailing Address - Phone:812-447-8405
Mailing Address - Fax:
Practice Address - Street 1:3114 DOMAIN CIR APT 102
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-3343
Practice Address - Country:US
Practice Address - Phone:812-447-8405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07403225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKN080541806OtherDRIVERS LICENCES