Provider Demographics
NPI:1326793407
Name:CHRISTY MERRELL MUSIC THERAPY
Entity Type:Organization
Organization Name:CHRISTY MERRELL MUSIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:314-619-9936
Mailing Address - Street 1:7466 TEASDALE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4047
Mailing Address - Country:US
Mailing Address - Phone:314-619-9936
Mailing Address - Fax:
Practice Address - Street 1:7466 TEASDALE AVE
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-4047
Practice Address - Country:US
Practice Address - Phone:314-619-9936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty