| NPI | 1003568510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANY HERNDON NYSTRAND Owner 229-400-0722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 225A00000X Music Therapist |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2025-10-07 |