Healthcare Provider Details

I. General information

NPI: 1316156003
Provider Name (Legal Business Name): ART THERAPY STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 FAIRHILL RD
CLEVELAND OH
44120-1058
US

IV. Provider business mailing address

12200 FAIRHILL RD
CLEVELAND OH
44120-1058
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-9303
  • Fax: 216-791-5610
Mailing address:
  • Phone: 216-791-9303
  • Fax: 216-791-5610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN B PETERSON
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A.
Phone: 216-791-9303