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Individual

MR. MICHAEL COLIN SISTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MT-BC

Contact information

Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
15831
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15831
CERTIFICATION BOARD OF MUSIC THERAPY
NY
Enumeration date
01/21/2021
Last updated
01/21/2021
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