Healthcare Provider Details

I. General information

NPI: 1578182796
Provider Name (Legal Business Name): GULF COAST MUSIC THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4744 SR64
BRADENTON FL
34208
US

IV. Provider business mailing address

4744 E SR64
BRADENTON FL
34208
US

V. Phone/Fax

Practice location:
  • Phone: 941-527-8477
  • Fax:
Mailing address:
  • Phone: 941-527-8477
  • 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: VIRGINIA A BIBLER
Title or Position: OWNER, CLINICAL DIRECTOR
Credential: MT-BC, NICU MT
Phone: 941-518-5468