Provider Demographics
NPI:1972684736
Name:MUSIC THERAPY SERVICES OF GREATER ATLANTA, LLC
Entity Type:Organization
Organization Name:MUSIC THERAPY SERVICES OF GREATER ATLANTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMPSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:NMT, MT-BC
Authorized Official - Phone:678-560-6560
Mailing Address - Street 1:114 BULLOCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075
Mailing Address - Country:US
Mailing Address - Phone:678-560-6565
Mailing Address - Fax:678-277-2633
Practice Address - Street 1:114 BULLOCH AVENUE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075
Practice Address - Country:US
Practice Address - Phone:678-560-6565
Practice Address - Fax:678-277-2633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty