# CREATIVE WELLNESS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144768516
- **Authorized official:** SUSAN IDA GARGUIOLO LMT (OWNER)
- **Authorized official phone:** (716) 310-6268

## Contact information

- **Practice address:** 726 MAIN ST UPPR, EAST AURORA, NY 14052-1904
- **Practice address phone:** (716) 310-6268
- **Mailing address:** 726 MAIN ST UPPR, EAST AURORA, NY 14052-1904
- **Mailing address phone:** (716) 310-6268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | 020819 | NY | Yes |

## Other

- **Enumeration date:** 02/06/2017
- **Last updated:** 02/06/2017