MEDICARE: CHRISTY MERRELL MT-BC

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	11690	MO

General Provider Information

NPI Number	:	1730875584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY MERRELL MT-BC

Provider Business Mailing Address
First Line	:	7466 TEASDALE AVE
Second Line	:
City	:	UNIVERSITY CITY
State	:	MO
Zip	:	63130-4047
Country	:	US
Telephone Number	:	314-619-9936
Fax Number	:

Provider Business Practice Location Address
First Line	:	7466 TEASDALE AVE
Second Line	:
City	:	UNIVERSITY CITY
State	:	MO
Zip	:	63130-4047
Country	:	US
Telephone Number	:	314-619-9936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2023
Last Update Date	:	04/14/2023

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Directions to “ CHRISTY MERRELL MT-BC” Practice Location

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