Healthcare Provider Details

I. General information

NPI: 1013508365
Provider Name (Legal Business Name): MELODY MUSIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1872 CHEROKEE ROSE CIR
MOUNT PLEASANT SC
29466-8003
US

IV. Provider business mailing address

1872 CHEROKEE ROSE CIR
MOUNT PLEASANT SC
29466-8003
US

V. Phone/Fax

Practice location:
  • Phone: 571-246-7210
  • Fax:
Mailing address:
  • Phone:
  • 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: SABRINA CLARK
Title or Position: OWNER/MUSIC THERAPIST
Credential:
Phone: 571-246-7210