Provider Demographics
NPI:1932521747
Name:MUSIC THERAPY IN MOTION, LLC
Entity Type:Organization
Organization Name:MUSIC THERAPY IN MOTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUSIC THERAPIST-BOARD CERTIFIED/LIC
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WANGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC/L
Authorized Official - Phone:218-791-0908
Mailing Address - Street 1:1606 DELLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5235
Mailing Address - Country:US
Mailing Address - Phone:218-791-0908
Mailing Address - Fax:
Practice Address - Street 1:1606 DELLWOOD CT
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-5235
Practice Address - Country:US
Practice Address - Phone:218-791-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND07974225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty