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General NPI Number Information
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NPI Number | 1487225611
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Entity Type | Organization
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Legal Business Name | DBC3 MUSIC THERAPY LLC
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 5145 E SPRAGUE RD
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City | INDEPENDENCE
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State | OH
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Zip | 44131-6231
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Country | US
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Telephone | 970-297-8506
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Fax |
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Provider Business Mailing Address
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Address Line | 5145 E SPRAGUE RD
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City | INDEPENDENCE
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State | OH
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Zip | 44131-6231
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Country | US
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Telephone | 970-297-8506
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DWYER CONKLYN
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Credential | MT-BC
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Telephone | 970-297-8506
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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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