Provider Demographics
NPI:1699164541
Name:LOUISVILLE MUSIC THERAPY
Entity type:Organization
Organization Name:LOUISVILLE MUSIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MM, MT-BC
Authorized Official - Phone:502-376-9064
Mailing Address - Street 1:3314 STONY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1538
Mailing Address - Country:US
Mailing Address - Phone:502-376-9064
Mailing Address - Fax:
Practice Address - Street 1:3314 STONY BROOK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1538
Practice Address - Country:US
Practice Address - Phone:502-376-9064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0686796225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty