Provider Demographics
NPI:1316509060
Name:RIBEIRO, CHLOE SAMANTHA (MA, MT-BC)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:SAMANTHA
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 VREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1618
Mailing Address - Country:US
Mailing Address - Phone:908-229-8117
Mailing Address - Fax:
Practice Address - Street 1:145 VREELAND AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1618
Practice Address - Country:US
Practice Address - Phone:908-229-8117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12990225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist