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General NPI Number Information
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NPI Number | 1164137774
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Entity Type | Organization
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Legal Business Name | CREEKSIDE THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 4760 HILLSIDE LN
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City | EDMOND
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State | OK
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Zip | 73025-1275
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Country | US
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Telephone | 405-724-4232
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Fax | 405-754-1152
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Provider Business Mailing Address
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Address Line | PO BOX 1622
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City | EDMOND
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State | OK
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Zip | 73083-1622
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Country | US
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Telephone | 405-724-4232
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Fax | 405-754-1152
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | EMILY BARSTOW
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Credential | M.S CCC-SLP
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Telephone | 405-220-3450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224ZF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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