Healthcare Provider Details

I. General information

NPI: 1144865478
Provider Name (Legal Business Name): CHILDRENS CORNER ART THERAPY FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2019
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 S UNIVERSITY DR STE 253
DAVIE FL
33328-3836
US

IV. Provider business mailing address

3312 SW 51ST ST
FORT LAUDERDALE FL
33312-7914
US

V. Phone/Fax

Practice location:
  • Phone: 55-424-0333
  • Fax:
Mailing address:
  • Phone: 305-542-4033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARGARET ELLEN DUNN-SNOW
Title or Position: OWNER
Credential: LMHC
Phone: 305-542-4033