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General NPI Number Information
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NPI Number | 1114486818
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Entity Type | Organization
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Legal Business Name | SUMMIT MUSIC THERAPY LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 516 LAYTON RD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9308
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Country | US
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Telephone | 570-862-2495
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Fax |
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Provider Business Mailing Address
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Address Line | 516 LAYTON RD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9308
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Country | US
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Telephone | 570-862-2495
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Fax |
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Authorized Official
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Title or Position | OWNER, MUSIC THERAPIST
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Name | CHERYL MOZDIAN
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Credential | MM, MT-BC
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Telephone | 570-862-2495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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