Healthcare Provider Details

I. General information

NPI: 1902948797
Provider Name (Legal Business Name): WISCONSIN CONSERVATORY OF MUSIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1584 N PROSPECT AVE
MILWAUKEE WI
53202-6501
US

IV. Provider business mailing address

1584 N PROSPECT AVE
MILWAUKEE WI
53202-6501
US

V. Phone/Fax

Practice location:
  • Phone: 414-276-5760
  • Fax: 414-276-6076
Mailing address:
  • Phone: 414-276-5760
  • Fax: 414-276-6076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN DESCHERE
Title or Position: PRESIDENT, CEO
Credential:
Phone: 414-276-5760