Healthcare Provider Details

I. General information

NPI: 1689596918
Provider Name (Legal Business Name): THERAPY MUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 E 2ND ST
SALIDA CO
81201-2808
US

IV. Provider business mailing address

324 E 2ND ST
SALIDA CO
81201-2808
US

V. Phone/Fax

Practice location:
  • Phone: 504-427-2699
  • Fax:
Mailing address:
  • Phone: 504-427-2699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TUYL MOGABGAB
Title or Position: OWNER
Credential: LCSW-BACS, MPH
Phone: 504-427-2699