Provider Demographics
NPI:1205286549
Name:MOVED BY MUSIC, LLC
Entity type:Organization
Organization Name:MOVED BY MUSIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MM, MTBC
Authorized Official - Phone:719-431-3549
Mailing Address - Street 1:41664 REDS RD
Mailing Address - Street 2:
Mailing Address - City:PAONIA
Mailing Address - State:CO
Mailing Address - Zip Code:81428-8310
Mailing Address - Country:US
Mailing Address - Phone:970-527-9138
Mailing Address - Fax:
Practice Address - Street 1:41664 REDS RD
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428-8310
Practice Address - Country:US
Practice Address - Phone:719-431-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty