Provider Demographics
NPI:1598158909
Name:MUSIK TO GROW
Entity Type:Organization
Organization Name:MUSIK TO GROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUSIC THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BONER
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:770-579-2554
Mailing Address - Street 1:2998 CHRISTOPHERS CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1631
Mailing Address - Country:US
Mailing Address - Phone:770-579-2554
Mailing Address - Fax:
Practice Address - Street 1:1517 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6493
Practice Address - Country:US
Practice Address - Phone:770-579-2554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000077261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities