Healthcare Provider Details

I. General information

NPI: 1326793407
Provider Name (Legal Business Name): CHRISTY MERRELL MUSIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7466 TEASDALE AVE
UNIVERSITY CITY MO
63130-4047
US

IV. Provider business mailing address

7466 TEASDALE AVE
UNIVERSITY CITY MO
63130-4047
US

V. Phone/Fax

Practice location:
  • Phone: 314-619-9936
  • Fax:
Mailing address:
  • Phone: 314-619-9936
  • 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: CHRISTY MERRELL
Title or Position: OWNER
Credential: MT-BC
Phone: 314-619-9936