Healthcare Provider Details

I. General information

NPI: 1013844307
Provider Name (Legal Business Name): WILDWOOD MUSIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 PROFESSIONAL HEIGHTS DR STE 180
LEXINGTON KY
40503-3021
US

IV. Provider business mailing address

2375 PROFESSIONAL HEIGHTS DR STE 180
LEXINGTON KY
40503-3021
US

V. Phone/Fax

Practice location:
  • Phone: 859-456-0292
  • Fax:
Mailing address:
  • Phone: 859-456-0292
  • 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: NORA VEBLEN
Title or Position: OWNER, MUSIC THERAPIST
Credential: MT-BC
Phone: 859-456-0292