Individual
YVONNE NICOLE DEGORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
3020 S FRONTAGE RD W, VAIL, CO 81657-4883
(704) 904-0303
Mailing address
PO BOX 1167, VAIL, CO 81658-1167
(704) 904-0303
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
07621
NC
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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