Provider Demographics
NPI:1902953946
Name:SINCLAIR, MIMI (MT-BC)
Entity Type:Individual
Prefix:
First Name:MIMI
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2018
Mailing Address - Country:US
Mailing Address - Phone:513-474-6064
Mailing Address - Fax:513-474-6064
Practice Address - Street 1:1708 BEACON ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2018
Practice Address - Country:US
Practice Address - Phone:513-474-6064
Practice Address - Fax:513-474-6064
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist