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General NPI Number Information
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NPI Number | 1619322914
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Entity Type | Organization
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Legal Business Name | NEW PALTZ CREATIVE ARTS THERAPY FOR TRAUMA PLLC
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 04/25/2016
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Provider Practice Location Address
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Address Line | 474 STATE ROUTE 32 N
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City | NEW PALTZ
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State | NY
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Zip | 12561-3040
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Country | US
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Telephone | 845-417-8301
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Fax |
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Provider Business Mailing Address
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Address Line | 474 STATE ROUTE 32 N
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City | NEW PALTZ
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State | NY
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Zip | 12561-3040
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Country | US
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Telephone | 845-417-8301
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | MS. LINDA E ERMAN
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Credential | MPS LCAT
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Telephone | 845-417-8301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 001667
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License Number State | NY
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