Provider Demographics
NPI:1619373610
Name:ALLIANCE MUSIC THERAPY, LLC
Entity Type:Organization
Organization Name:ALLIANCE MUSIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUSIC THERAPIST - BOARD CERTIFIED
Authorized Official - Prefix:MS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MT-BC
Authorized Official - Phone:651-492-3399
Mailing Address - Street 1:833 GREAT OAKS TRL
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2435
Mailing Address - Country:US
Mailing Address - Phone:651-492-3399
Mailing Address - Fax:
Practice Address - Street 1:833 GREAT OAKS TRL
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2435
Practice Address - Country:US
Practice Address - Phone:651-492-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty