Provider Demographics
NPI:1669065702
Name:SHENANDOAH ART THERAPY, LLC
Entity type:Organization
Organization Name:SHENANDOAH ART THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR & ART THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUOMISTO
Authorized Official - Suffix:
Authorized Official - Credentials:ATR-BC, CTT
Authorized Official - Phone:540-255-1458
Mailing Address - Street 1:1835 ROSSER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-3284
Mailing Address - Country:US
Mailing Address - Phone:540-255-1458
Mailing Address - Fax:571-482-6060
Practice Address - Street 1:1835 ROSSER AVE STE 2
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3284
Practice Address - Country:US
Practice Address - Phone:540-255-1458
Practice Address - Fax:571-482-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty