Healthcare Provider Details

I. General information

NPI: 1922739721
Provider Name (Legal Business Name): MIXED MELODY MUSIC CENTER, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26121 CENTER RIDGE RD
WESTLAKE OH
44145-4015
US

IV. Provider business mailing address

26121 CENTER RIDGE RD
WESTLAKE OH
44145-4015
US

V. Phone/Fax

Practice location:
  • Phone: 440-250-0091
  • Fax:
Mailing address:
  • Phone: 440-250-0091
  • 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: MAGGIE MCALLISTER
Title or Position: CO-DIRECTOR
Credential: MT-BC
Phone: 440-250-0091