Healthcare Provider Details

I. General information

NPI: 1023026648
Provider Name (Legal Business Name): MUSIC THERAPY ASSOCIATES OF EAST TENNESSEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E GROVE ST
GREENEVILLE TN
37745-5005
US

IV. Provider business mailing address

101 E GROVE ST
GREENEVILLE TN
37745-5005
US

V. Phone/Fax

Practice location:
  • Phone: 423-639-7959
  • Fax: 423-783-9983
Mailing address:
  • Phone: 423-639-7959
  • Fax: 423-783-9983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT0000005528
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETH JEANNETTE ROBERTSON
Title or Position: PRESIDENT
Credential: MM, MT-BC
Phone: 423-639-7959