Healthcare Provider Details

I. General information

NPI: 1700768413
Provider Name (Legal Business Name): MADISON ROSE MARCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON ROSE NASH MT-BC

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3588 PLYMOUTH RD # 393
ANN ARBOR MI
48105-2603
US

IV. Provider business mailing address

443 CHASSERAL DR NW APT 2A
COMSTOCK PARK MI
49321-9153
US

V. Phone/Fax

Practice location:
  • Phone: 734-352-3543
  • Fax:
Mailing address:
  • Phone: 616-577-2635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number18248
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: