Healthcare Provider Details

I. General information

NPI: 1922588136
Provider Name (Legal Business Name): SHILOH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 LINCOLN DR
ANNAPOLIS MD
21401-4118
US

IV. Provider business mailing address

1907 LINCOLN DR
ANNAPOLIS MD
21401-4118
US

V. Phone/Fax

Practice location:
  • Phone: 410-697-1812
  • Fax:
Mailing address:
  • Phone: 410-697-1812
  • 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: MRS. CHRISTY JOY SHILOH
Title or Position: OWNER AND DIRECTOR OF SERVICES
Credential: MT-BC
Phone: 410-697-1812