# CREATIVE WONDERS OT PT SLP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** wonderkids therapy center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306098553
- **Authorized official:** DAVID GREEN OTR/L (OWNER AND DIRECTOR)
- **Authorized official phone:** (914) 421-8270

## Contact information

- **Practice address:** 470 MAMARONECK AVE, SUITE 204, WHITE PLAINS, NY 10605-1830
- **Practice address phone:** (914) 421-8270
- **Mailing address:** 470 MAMARONECK AVE STE 412, WHITE PLAINS, NY 10605-1839
- **Mailing address phone:** (914) 421-8270
- **Mailing address fax:** (914) 421-8272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/21/2008
- **Last updated:** 02/16/2022