Healthcare Provider Details

I. General information

NPI: 1811103088
Provider Name (Legal Business Name): EDWARD TODD SCHWARTZBERG PHD., MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FERGUSON HALL 2106 4TH STREETH SOUTH
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

2088 SANDHILL DR
SHAKOPEE MN
55379-5902
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-6016
  • Fax:
Mailing address:
  • Phone: 763-234-1841
  • 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:
Title or Position:
Credential:
Phone: