MEDICARE: MERAKI MUSIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist	12110

General Provider Information

NPI Number	:	1013413749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERAKI MUSIC

Provider Business Mailing Address
First Line	:	448 W 19TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3914
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	448 W 19TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3914
Country	:	US
Telephone Number	:	210-748-6005
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED MUSIC THERAPIST
Name	:	MEGAN JOSEPH
Credential	:	MT-BC
Telephone Number	:	210-748-6005

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	04/02/2018

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