Provider Demographics
NPI:1245846880
Name:MCS MUSIC THERAPY LLC
Entity type:Organization
Organization Name:MCS MUSIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND MUSIC THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:MARIANELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVRIES
Authorized Official - Suffix:
Authorized Official - Credentials:MMT, MT-BC
Authorized Official - Phone:561-703-1403
Mailing Address - Street 1:PO BOX 290793
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-0793
Mailing Address - Country:US
Mailing Address - Phone:561-703-1403
Mailing Address - Fax:
Practice Address - Street 1:3850 S UNIVERSITY DR UNIT 290793
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33329-8437
Practice Address - Country:US
Practice Address - Phone:561-703-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty