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General NPI Number Information
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NPI Number | 1245715770
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Entity Type | Organization
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Legal Business Name | CREATIVE ALTERNATIVES
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 17 HAMRE LN
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City | BRANFORD
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State | CT
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Zip | 06405-3709
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Country | US
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Telephone | 203-645-2943
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Fax |
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Provider Business Mailing Address
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Address Line | 17 HAMRE LN
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City | BRANFORD
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State | CT
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Zip | 06405-3709
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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 | AGENT
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Name | LAURA ANGELA SPINELLI
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Credential | LPC, ATR
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Telephone | 203-645-2943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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