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General NPI Number Information
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NPI Number | 1285218776
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Entity Type | Organization
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Legal Business Name | MOXIE MUSIC THERAPY, LLC
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 4804 HILLSPRING CIR UNIT B
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City | AUSTIN
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State | TX
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Zip | 78721-1605
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Country | US
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Telephone | 512-914-0339
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Fax |
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Provider Business Mailing Address
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Address Line | 4804 HILLSPRING CIR UNIT B
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City | AUSTIN
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State | TX
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Zip | 78721-1605
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Country | US
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Telephone | 512-914-0339
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Fax |
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Authorized Official
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Title or Position | MUSIC THERAPIST/OWNER
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Name | ANNE VANDERVOORT
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Credential | MM, MT-BC
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Telephone | 512-914-0339
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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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