Provider Demographics
NPI:1205521119
Name:MUSIC IZZ GROOVY - MUSIC SERVICES, LLC
Entity type:Organization
Organization Name:MUSIC IZZ GROOVY - MUSIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISABELLA
Authorized Official - Middle Name:MARISSA
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:440-212-8718
Mailing Address - Street 1:6659 PEARL RD STE 302
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3821
Mailing Address - Country:US
Mailing Address - Phone:216-202-4803
Mailing Address - Fax:
Practice Address - Street 1:6659 PEARL RD STE 302
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3821
Practice Address - Country:US
Practice Address - Phone:216-202-4803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty