Individual
CLARA TEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC, NMT
Contact information
Practice address
401 E PROSPECT AVE STE 208, MOUNT PROSPECT, IL 60056-3396
(734) 476-9712
Mailing address
1619 W FARGO AVE APT 3, CHICAGO, IL 60626-1768
(734) 476-9712
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
16091
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16091
CERTIFICATION BOARD FOR MUSIC THERAPISTS
—
Enumeration date
11/12/2021
Last updated
11/12/2021
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