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Individual

KAITLYN MARIE UPSHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, MT-BC, LCAT-LP

Contact information

Practice address
135 ENGINEERS RD STE 190, HAUPPAUGE, NY 11788-4031
(631) 615-1935
Mailing address
24 EASTBOURNE CRES, EAST PATCHOGUE, NY 11772-4838
(631) 335-3610

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
P114930
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P114930
CREATIVE ARTS THERAPY - LIMTED PERMIT
NY
Enumeration date
05/10/2022
Last updated
05/10/2022
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