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General NPI Number Information
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NPI Number | 1003321415
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Entity Type | Organization
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Legal Business Name | CREATIVE BEHAVIORAL SOLUTIONS LLC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 8025 PARSONS BLVD
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City | JAMAICA
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State | NY
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Zip | 11432-1052
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Country | US
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Telephone | 718-938-1256
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 PARSONS BLVD
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City | JAMAICA
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State | NY
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Zip | 11432-1052
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE
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Name | MR. DEMETRIUS FINCHER
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Credential | LMSW
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Telephone | 347-756-2455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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