Provider Demographics
NPI:1942711320
Name:MUZIQUE
Entity Type:Organization
Organization Name:MUZIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLY
Authorized Official - Middle Name:BLYNN
Authorized Official - Last Name:MUZALIER
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:609-670-8619
Mailing Address - Street 1:500 CHEWS LANDING RD APT 710
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6727
Mailing Address - Country:US
Mailing Address - Phone:609-670-8619
Mailing Address - Fax:
Practice Address - Street 1:1 S BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4609
Practice Address - Country:US
Practice Address - Phone:609-670-8619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Multi-Specialty