Healthcare Provider Details

I. General information

NPI: 1013211374
Provider Name (Legal Business Name): WB MUSIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2010
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7728 GREEN HILL RD
HARRISBURG PA
17112-9746
US

IV. Provider business mailing address

7728 GREEN HILL RD
HARRISBURG PA
17112-9746
US

V. Phone/Fax

Practice location:
  • Phone: 717-468-1684
  • Fax: 717-566-6556
Mailing address:
  • Phone: 717-468-1684
  • Fax: 717-566-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number06637
License Number StatePA

VIII. Authorized Official

Name: MRS. MELANIE ANNE WALBORN
Title or Position: MANAGING PARTNER/MUSIC THERAPIST
Credential: MT-BC
Phone: 717-468-1684