Provider Demographics
NPI:1174019491
Name:DLE MUSIC THERAPY, LLC
Entity type:Organization
Organization Name:DLE MUSIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENHOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:240-498-8173
Mailing Address - Street 1:1 GARRETT CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1507
Mailing Address - Country:US
Mailing Address - Phone:240-498-8173
Mailing Address - Fax:
Practice Address - Street 1:4306 DRESDEN ST
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-4101
Practice Address - Country:US
Practice Address - Phone:202-826-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty