Brian Herzog, MT-BC, NMT
Individual provider Active NPI Music Therapist · Iberia, MO
NPI 1700332020 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1700332020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Music Therapist 225A00000X
- Practice address
- 451 Tavern Creek Rd
Iberia, MO 65486-9193 - Phone
- (573) 480-1921
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | Yes |
Addresses
Primary practice location
451 Tavern Creek Rd
Iberia, MO 65486-9193
Mailing address
PO Box 363
Camdenton, MO 65020
Phone (573) 480-1921
Other providers in Iberia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.