Provider Demographics
NPI:1215474051
Name:K AND M MUSIC THERAPY LLC
Entity type:Organization
Organization Name:K AND M MUSIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUSIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-730-3627
Mailing Address - Street 1:1220 SCRUB OAK RD
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-2863
Mailing Address - Country:US
Mailing Address - Phone:630-730-3627
Mailing Address - Fax:
Practice Address - Street 1:1220 SCRUB OAK RD
Practice Address - Street 2:
Practice Address - City:MANITOU SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80829-2863
Practice Address - Country:US
Practice Address - Phone:630-730-3627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12050225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty