Organization
CREATIVELY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA CISNEROS LCPC (SOLE PROPRIETOR)
(443) 741-2294
Entity
Organization
Contact information
Practice address
5570 STERRETT PL, STE 100, COLUMBIA, MD 21044-2641
(443) 741-2294
Mailing address
9379 RUSTLING LEAF, COLUMBIA, MD 21045-5212
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
701006308
VA
251S00000X
Community/Behavioral Health Agency
Primary
LC4473
MD
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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