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General NPI Number Information
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NPI Number | 1740848274
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Entity Type | Organization
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Legal Business Name | MADISON AREA MUSIC THERAPY, LLC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1316 SWORDLEAF LN
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-4317
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Country | US
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Telephone | 715-370-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 SWORDLEAF LN
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-4317
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Country | US
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Telephone | 715-370-8262
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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 | DANIELLE M RIECKHOFF
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Credential | MT-BC, WMTR
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Telephone | 715-370-8262
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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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