Organization Name: | CREATIVE EXPRESSIONS COUNSELING AND PLAY THERAPY LLC |
NPI Number: | 1861805731 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LANA DANIELLE GREENE (OWNER) |
Mailing Address: | 321 N Main St Suite C Adairsville |
State: | GA US |
Postal Code: | 301032438 |
Phone Number: | 6784690349 |
Fax Number: | 7707731500 |
NPI Enumeration Date: | 06/08/2014 |
NPI Last Update Date: | 06/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 006484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |