Healthcare Provider Details

I. General information

NPI: 1336527290
Provider Name (Legal Business Name): ART OF THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 KIRKWOOD HWY
NEWARK DE
19711-5716
US

IV. Provider business mailing address

3100 SKYLINE DR
WILMINGTON DE
19808-2816
US

V. Phone/Fax

Practice location:
  • Phone: 484-844-9890
  • Fax:
Mailing address:
  • Phone: 484-844-9890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC007940
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberMSG008037
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberMT-0003864
License Number StateDE

VIII. Authorized Official

Name: CYNTHIA E NORMAN
Title or Position: PRESIDENT
Credential: LPC
Phone: 443-941-4206