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General NPI Number Information
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NPI Number | 1972317931
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Entity Type | Organization
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Legal Business Name | CREATIVE GROWTH THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 10 MECHANIC ST APT B
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City | SACO
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State | ME
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Zip | 04072-2726
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Country | US
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Telephone | 530-414-5675
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MECHANIC ST APT B
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City | SACO
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State | ME
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Zip | 04072-2726
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Country | US
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Telephone | 530-414-5675
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA JEAN MCMASTER
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Credential | M.S., SLP-CCC
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Telephone | 530-414-5675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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