Provider Demographics
NPI:1245727742
Name:RESONATE MUSIC THERAPY LLC
Entity type:Organization
Organization Name:RESONATE MUSIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MUSIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:FERL
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:719-492-5282
Mailing Address - Street 1:4670 WINEWOOD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1221
Mailing Address - Country:US
Mailing Address - Phone:719-492-5282
Mailing Address - Fax:
Practice Address - Street 1:4670 WINEWOOD VILLAGE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-1221
Practice Address - Country:US
Practice Address - Phone:719-492-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12894225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty