Healthcare Provider Details

I. General information

NPI: 1467054403
Provider Name (Legal Business Name): CREATIVE REMEDIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12341 E CORNELL AVE # 18
AURORA CO
80014-3323
US

IV. Provider business mailing address

12341 E CORNELL AVE # 18
AURORA CO
80014-3323
US

V. Phone/Fax

Practice location:
  • Phone: 972-979-4615
  • Fax:
Mailing address:
  • Phone: 972-979-4615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANASTASIA CANFIELD
Title or Position: OWNER/OPERATOR
Credential:
Phone: 972-979-4615