Organization
CREATIVE ROOTS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN ELIZABETH SPIER LPC (OWNER/THERAPIST)
(541) 808-4719
Entity
Organization
Contact information
Practice address
375 PARK AVE, SUITE B, COOS BAY, OR 97420
(541) 808-4719
Mailing address
PO BOX 576, COOS BAY, OR 97420
(541) 808-4719
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3450
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673890
—
OR
Enumeration date
04/30/2015
Last updated
07/18/2015
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