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General NPI Number Information
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NPI Number | 1619373610
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Entity Type | Organization
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Legal Business Name | ALLIANCE MUSIC THERAPY, LLC
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 833 GREAT OAKS TRL
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City | EAGAN
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State | MN
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Zip | 55123-2435
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Country | US
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Telephone | 651-492-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 833 GREAT OAKS TRL
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City | EAGAN
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State | MN
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Zip | 55123-2435
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Country | US
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Telephone | 651-492-3399
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Fax |
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Authorized Official
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Title or Position | MUSIC THERAPIST - BOARD CERTIFIED
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Name | MS. HILARY A FREDENBURG
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Credential | MA, MT-BC
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Telephone | 651-492-3399
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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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