Provider Demographics
NPI:1790052850
Name:COMPASS MUSIC THERAPY, LLC
Entity Type:Organization
Organization Name:COMPASS MUSIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MUSIC THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:EDGELL
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MT-BC
Authorized Official - Phone:260-602-2568
Mailing Address - Street 1:643 RIDGEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4821
Mailing Address - Country:US
Mailing Address - Phone:260-602-2568
Mailing Address - Fax:
Practice Address - Street 1:643 RIDGEFIELD CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4821
Practice Address - Country:US
Practice Address - Phone:410-969-7399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06805225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty