Provider Demographics
NPI:1194023713
Name:MEYER MUSIC THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:MEYER MUSIC THERAPY SERVICES, INC
Other - Org Name:MUSIC THERAPY SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-474-0109
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-0746
Mailing Address - Country:US
Mailing Address - Phone:262-474-0109
Mailing Address - Fax:262-474-0102
Practice Address - Street 1:1525 WISCONSIN AVE
Practice Address - Street 2:SUITE 141
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-1975
Practice Address - Country:US
Practice Address - Phone:262-474-0109
Practice Address - Fax:262-474-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-06
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI09088225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty