Provider Demographics
NPI:1003786302
Name:BACK MOUNTAIN MUSIC THERAPY, THE HEYWARD ROOMS LLC
Entity type:Organization
Organization Name:BACK MOUNTAIN MUSIC THERAPY, THE HEYWARD ROOMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MUSIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:570-574-6822
Mailing Address - Street 1:1108 TWIN STACKS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-8505
Mailing Address - Country:US
Mailing Address - Phone:570-574-1707
Mailing Address - Fax:
Practice Address - Street 1:1108 TWIN STACKS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-8505
Practice Address - Country:US
Practice Address - Phone:570-574-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty