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General NPI Number Information
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NPI Number | 1336786482
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Entity Type | Organization
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Legal Business Name | INTUITIVE WELLNESS CREATIVE ARTS
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 3980 EVE DR
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City | SEAFORD
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State | NY
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Zip | 11783-1553
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Country | US
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Telephone | 631-848-8977
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Fax |
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Provider Business Mailing Address
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Address Line | 3980 EVE DR
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City | SEAFORD
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State | NY
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Zip | 11783-1553
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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 | CREATIVE ARTS THERAPIST
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Name | VICTORIA CASTAIN
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Credential | LCAT
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Telephone | 631-848-8977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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