Healthcare Provider Details

I. General information

NPI: 1285004119
Provider Name (Legal Business Name): GSUS MUSIC THERAPY SERVICES & CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 MORNINGWOOD DR
SAN MARCOS TX
78666-8452
US

IV. Provider business mailing address

PO BOX 1576
SAN MARCOS TX
78667-1576
US

V. Phone/Fax

Practice location:
  • Phone: 512-754-9631
  • 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: MR. CHRISTOPHER LIPPKE
Title or Position: CO-OWNER, MUSIC THERAPIST
Credential: MT-BC
Phone: 512-754-9631