Organization
BAY AREA MUSIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN F WILKERSON MT-BC (CEO/MUSIC THERAPIST)
(707) 595-0995
Entity
Organization
Contact information
Practice address
1924 RUSSELL AVE, SANTA ROSA, CA 95403-2647
(707) 595-0995
Mailing address
1007 W COLLEGE AVE # 176, SANTA ROSA, CA 95401-5046
(707) 595-0995
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
CA
Other
Enumeration date
01/29/2017
Last updated
01/29/2017
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