Provider Demographics
NPI:1801477567
Name:NOTEABLE MUSIC THERAPY SERVICES OF MN, LLC
Entity type:Organization
Organization Name:NOTEABLE MUSIC THERAPY SERVICES OF MN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUPP
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:507-581-2957
Mailing Address - Street 1:1608 W 156TH ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-5397
Mailing Address - Country:US
Mailing Address - Phone:507-581-2957
Mailing Address - Fax:
Practice Address - Street 1:17645 JUNIPER PATH STE 205
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-7491
Practice Address - Country:US
Practice Address - Phone:507-581-2957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty