Healthcare Provider Details

I. General information

NPI: 1437578390
Provider Name (Legal Business Name): JOYFUL MUSIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 LEE RD
WINTER PARK FL
32789-1755
US

IV. Provider business mailing address

719 LEE RD
ORLANDO FL
32810-5621
US

V. Phone/Fax

Practice location:
  • Phone: 407-489-1783
  • Fax:
Mailing address:
  • Phone: 407-489-1783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number08509
License Number StateFL

VIII. Authorized Official

Name: MISS TAMELA PONDER
Title or Position: EXECUTIVE DIRECTOR
Credential: MT-BC
Phone: 407-489-1783