Healthcare Provider Details

I. General information

NPI: 1407460728
Provider Name (Legal Business Name): BREAKTHROUGH MUSIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 E WASHINGTON ST
ELIZABETHTOWN PA
17022-2332
US

IV. Provider business mailing address

15 HEATHER CIR
ELIZABETHTOWN PA
17022-1416
US

V. Phone/Fax

Practice location:
  • Phone: 717-256-3942
  • Fax:
Mailing address:
  • Phone: 717-256-3942
  • 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: BENJAMIN DOWS
Title or Position: OWNER, MUSIC THERAPIST
Credential: MT-BC
Phone: 717-256-3942