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General NPI Number Information
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NPI Number | 1114722733
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Entity Type | Organization
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Legal Business Name | ITS YOURS CREATIVE ARTS THERAPY PLLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 2358 98TH ST APT B
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City | EAST ELMHURST
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State | NY
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Zip | 11369-1224
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Country | US
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Telephone | 929-468-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 2358 98TH ST
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City | EAST ELMHURST
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State | NY
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Zip | 11369-1224
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Country | US
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Telephone | 929-468-4412
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS JENNIFER T RICHARDS
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Credential | LCAT
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Telephone | 192-946-8441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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License Number |
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License Number State |
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