Provider Demographics
NPI:1518205467
Name:MIND-FULL MUSIC THERAPY SERVICES
Entity Type:Organization
Organization Name:MIND-FULL MUSIC THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRET
Authorized Official - Suffix:
Authorized Official - Credentials:MM, MT-BC, NMT
Authorized Official - Phone:480-363-9524
Mailing Address - Street 1:PO BOX 67777
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-7777
Mailing Address - Country:US
Mailing Address - Phone:480-363-9524
Mailing Address - Fax:
Practice Address - Street 1:327 E BEATRYCE ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1001
Practice Address - Country:US
Practice Address - Phone:480-363-9524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
No252Y00000XAgenciesEarly Intervention Provider Agency