Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 1744R1102X | Specialist | Research Study | | | No |
| 2 | 221700000X | Art Therapist | | | | No |
| 3 | 225700000X | Massage Therapist | | | | No |
| 4 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 5 | 374K00000X | Religious Nonmedical Practitioner | | | | No |
| 6 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |