Healthcare Provider Details

I. General information

NPI: 1124614730
Provider Name (Legal Business Name): COLORADO MUSIC THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E BASELINE RD
LAFAYETTE CO
80026-2404
US

IV. Provider business mailing address

693 MEAD CT
LOUISVILLE CO
80027-2079
US

V. Phone/Fax

Practice location:
  • Phone: 303-204-9286
  • Fax:
Mailing address:
  • Phone: 303-204-9286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. AMANDA LEE BRIGHAM
Title or Position: BOARD CERTIFIED MUSIC THERAPIST
Credential: MM, MT-BC
Phone: 303-204-9286