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General NPI Number Information
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NPI Number | 1255631818
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Entity Type | Organization
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Legal Business Name | CREATIVE PLAY SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 671 LUMPKIN CAMPGROUND RD S SUITE 240
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0922
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Country | US
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Telephone | 706-216-5072
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Fax |
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Provider Business Mailing Address
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Address Line | 671 LUMPKIN CAMPGROUND RD S SUITE 240
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0922
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Country | US
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Telephone | 706-216-5072
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | JENNIFER HOSEA
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Credential |
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Telephone | 706-216-5072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3106
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License Number State | GA
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