Provider Demographics
NPI:1659742930
Name:DBA DEVELOPING MELODIES
Entity Type:Organization
Organization Name:DBA DEVELOPING MELODIES
Other - Org Name:DEVELOPING MELODIES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, MUSIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MERY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MM, MT-BC, DT
Authorized Official - Phone:309-212-6204
Mailing Address - Street 1:211 S PROSPECT RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 S PROSPECT RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4910
Practice Address - Country:US
Practice Address - Phone:309-212-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty