Provider Demographics
NPI:1669566832
Name:MUSIC THERAPY SERVICES OF WAUKESHA COUNTY, LLC
Entity type:Organization
Organization Name:MUSIC THERAPY SERVICES OF WAUKESHA COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUSIC THERAPIST, OWNER & DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEXTER - SCHABOW
Authorized Official - Suffix:
Authorized Official - Credentials:MMT, MT-BC, WMTR
Authorized Official - Phone:262-367-6663
Mailing Address - Street 1:1125 JAMES DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8310
Mailing Address - Country:US
Mailing Address - Phone:262-367-6663
Mailing Address - Fax:262-367-3056
Practice Address - Street 1:1125 JAMES DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8310
Practice Address - Country:US
Practice Address - Phone:262-367-6663
Practice Address - Fax:262-367-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center