Healthcare Provider Details

I. General information

NPI: 1093966947
Provider Name (Legal Business Name): THE MUSIC THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7840 MISSION CENTER CT SUITE 205
SAN DIEGO CA
92108-1319
US

IV. Provider business mailing address

7840 MISSION CENTER CT SUITE 205
SAN DIEGO CA
92108-1319
US

V. Phone/Fax

Practice location:
  • Phone: 619-299-1411
  • Fax: 619-299-1412
Mailing address:
  • Phone: 619-299-1411
  • Fax: 619-299-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15258
License Number StateCA

VIII. Authorized Official

Name: MS. ANGELA LYNN NEVE
Title or Position: OWNER/PRESIDENT
Credential: MT-BC, NMT
Phone: 619-299-1411