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Organization

TIDEWATER MUSIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE HARNEY MT-BC (MUSIC THERAPIST)
(757) 255-8866
Entity
Organization

Contact information

Practice address
4030 GEORGE WASHINGTON MEM HWY STE C, YORKTOWN, VA 23692-2619
(757) 255-8866
Mailing address
4030 GEORGE WASHINGTON MEM HWY STE C, YORKTOWN, VA 23692-2619

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174201164
VA
05
1366124919
VA
05
1528746807
VA
05
30018454480001
VA
Enumeration date
01/09/2026
Last updated
05/12/2026
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