Organization
CREATIVE KIDS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HADEN MS CCC-SLP (OWNER)
(903) 641-5186
Entity
Organization
Contact information
Practice address
3112 W STATE HIGHWAY 22, CORSICANA, TX 75110-2435
(903) 641-5186
Mailing address
3112 W STATE HIGHWAY 22, CORSICANA, TX 75110-2435
(903) 257-3683
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/03/2022
Last updated
10/15/2024
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