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Individual

MICHAEL COLLERAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MT-BC

Contact information

Practice address
3151 STONY ST, MOHEGAN LAKE, NY 10547-1913
(914) 885-1995
Mailing address
3151 STONY ST, MOHEGAN LAKE, NY 10547-1913

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
16213

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16213
CERTIFICATION BOARD OF MUSIC THERAPISTS ID #
Enumeration date
01/06/2022
Last updated
01/06/2022
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