Provider Demographics
NPI:1710542550
Name:STEPHANIE SAKLAD, CREATIVE ARTS THERAPY, PLLC
Entity Type:Organization
Organization Name:STEPHANIE SAKLAD, CREATIVE ARTS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ART THERAPIST/ PRACTICE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LCAT
Authorized Official - Phone:516-659-0403
Mailing Address - Street 1:7835 147TH ST APT 1E
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3587
Mailing Address - Country:US
Mailing Address - Phone:516-659-0403
Mailing Address - Fax:
Practice Address - Street 1:7021 170TH ST STE 1
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-3331
Practice Address - Country:US
Practice Address - Phone:516-659-0403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty