Provider Demographics
NPI:1437469673
Name:CREATIVE THERAPY
Entity Type:Organization
Organization Name:CREATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:845-380-5910
Mailing Address - Street 1:74 LAMB AVE
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-2113
Mailing Address - Country:US
Mailing Address - Phone:845-380-5910
Mailing Address - Fax:845-246-4240
Practice Address - Street 1:74 LAMB AVE
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-2113
Practice Address - Country:US
Practice Address - Phone:845-380-5910
Practice Address - Fax:845-246-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0202051252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency