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General NPI Number Information
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NPI Number | 1558500231
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Entity Type | Organization
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Legal Business Name | THERABEAT, INC.
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 310 PAPER TRAIL WAY SUITE 302
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City | CANTON
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State | GA
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Zip | 30115-5203
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Country | US
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Telephone | 770-345-2804
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Fax | 678-827-0927
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Provider Business Mailing Address
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Address Line | 9880 HICKORY FLAT HWY
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City | WOODSTOCK
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State | GA
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Zip | 30188-3081
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Country | US
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Telephone | 770-687-2542
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Fax | 770-783-5049
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Authorized Official
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Title or Position | MUSIC THERAPIST/DIRECTOR
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Name | MRS. JENNIFER WALKER PUCKETT
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Credential | MT-BC, NMT
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Telephone | 770-687-2542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 07335
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License Number State | GA
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