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General NPI Number Information
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NPI Number | 1134741713
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Entity Type | Organization
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Legal Business Name | CREATIVE AND MEANINGFUL PLAY C.A.M.P. THERAPY CENTER
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Dates
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Enumeration Date | 05/17/2020
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 1106 8TH ST STE A
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City | WICHITA FALLS
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State | TX
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Zip | 76301-2324
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Country | US
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Telephone | 513-404-6370
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 TILDEN ST
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City | WICHITA FALLS
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State | TX
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Zip | 76309-3116
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Country | US
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Telephone | 513-404-6370
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Fax |
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Authorized Official
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Title or Position | OWNER/REGISTERED AGENT
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Name | VANESSA KATHLEEN HALTER
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Credential |
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Telephone | 513-404-6370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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