Healthcare Provider Details

I. General information

NPI: 1831523059
Provider Name (Legal Business Name): MUSIC THERAPY WITH ERIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 08/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 SNELLING AVE N #A, SUITE 6
SAINT PAUL MN
55104-2878
US

IV. Provider business mailing address

625 SNELLING AVE N #A, SUITE 6
SAINT PAUL MN
55104-2878
US

V. Phone/Fax

Practice location:
  • Phone: 763-360-2291
  • Fax:
Mailing address:
  • Phone: 763-360-2291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: ERIN MARGARET-CAMPBELL SHIELDS
Title or Position: MUSIC THERAPIST
Credential: M.A., MT-BC, NMT
Phone: 763-360-2291