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General NPI Number Information
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NPI Number | 1699398388
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Entity Type | Organization
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Legal Business Name | STELLASDREAM ART THERAPY & COUNSELING
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 8500 STATION ST STE 112
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City | MENTOR
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State | OH
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Zip | 44060-4962
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Country | US
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Telephone | 440-251-9325
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Fax | 440-549-0935
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Provider Business Mailing Address
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Address Line | 8500 STATION ST STE 112
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City | MENTOR
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State | OH
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Zip | 44060-4962
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Country | US
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Telephone | 440-251-9325
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Fax | 440-549-0935
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | JANEANE GRISEZ
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Credential | LPCC-S, LICDC-CS
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Telephone | 440-251-9325
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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 |
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License Number State |
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