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Organization
CREATIVE THERAPY WORKS LLC
Active
Organization
CREATIVE THERAPY WORKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE GILES (OWNER/ SPEECH PATHOLOGIST)
(866) 611-7855
Entity
Organization
Contact information
Practice address
4530 LUCERNE LN SW, LILBURN, GA 30047-4529
(866) 611-7855
Mailing address
4530 LUCERNE LN SW, LILBURN, GA 30047-4529
(866) 611-7855
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007162
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112414A
—
GA
Enumeration date
07/15/2011
Last updated
10/14/2011
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