MEDICARE: NEUROSONG MUSIC THERAPY SERVICES, INC.

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

General Provider Information

NPI Number	:	1518043892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROSONG MUSIC THERAPY SERVICES, INC.

Provider Business Mailing Address
First Line	:	1327 HEARTHFIRE CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-1782
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1327 HEARTHFIRE CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-1782
Country	:	US
Telephone Number	:	970-988-5326
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIMBERLY MARY SENA MOORE
Credential	:	MM, MT-BC, NMT
Telephone Number	:	970-988-5326

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	08/22/2020

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