Healthcare Provider Details

I. General information

NPI: 1922439306
Provider Name (Legal Business Name): PLAY YOUR PART, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 LATITUDE
IRVINE CA
92618-8821
US

IV. Provider business mailing address

31 LATITUDE
IRVINE CA
92618-8821
US

V. Phone/Fax

Practice location:
  • Phone: 855-538-7797
  • Fax: 855-538-7797
Mailing address:
  • Phone: 855-538-7797
  • Fax: 855-538-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number09555
License Number StateCA

VIII. Authorized Official

Name: MRS. BRIANNA SHAFFER
Title or Position: FOUNDER, MUSIC THERAPIST
Credential: MT-BC, NMT
Phone: 855-538-7797