Healthcare Provider Details

I. General information

NPI: 1336817014
Provider Name (Legal Business Name): RAE THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E THOMAS RD STE 115
PHOENIX AZ
85016-8222
US

IV. Provider business mailing address

2601 E THOMAS RD STE 115
PHOENIX AZ
85016-8222
US

V. Phone/Fax

Practice location:
  • Phone: 715-383-5442
  • Fax:
Mailing address:
  • Phone: 715-383-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: EMMA SCHEETS
Title or Position: OWNER AND DIRECTOR
Credential: CCLS
Phone: 715-383-5442