Provider Demographics
NPI:1710009576
Name:ART THERAPY STUDIO
Entity Type:Organization
Organization Name:ART THERAPY STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ART THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR
Authorized Official - Phone:216-778-4709
Mailing Address - Street 1:12200 FAIRHILL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1058
Mailing Address - Country:US
Mailing Address - Phone:216-791-9303
Mailing Address - Fax:216-791-5610
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-4709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty