Provider Demographics
NPI:1538119565
Name:CREATIVE CHILDREN THERAPY
Entity Type:Organization
Organization Name:CREATIVE CHILDREN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:ORFILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-412-4177
Mailing Address - Street 1:15464 SW 95TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1145
Mailing Address - Country:US
Mailing Address - Phone:305-380-0103
Mailing Address - Fax:
Practice Address - Street 1:12608 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1867
Practice Address - Country:US
Practice Address - Phone:305-412-4177
Practice Address - Fax:305-412-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3769235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty