Provider Demographics
NPI:1497113385
Name:CREATIVE EXPRESSION THERAPY
Entity Type:Organization
Organization Name:CREATIVE EXPRESSION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARTHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-917-5268
Mailing Address - Street 1:4717 VAN NUYS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2149
Mailing Address - Country:US
Mailing Address - Phone:818-917-5268
Mailing Address - Fax:
Practice Address - Street 1:4717 VAN NUYS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2149
Practice Address - Country:US
Practice Address - Phone:818-917-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty