Organization
ENCHANTED COTTAGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SULLIVAN (CREDENTIALING SPECIALIST)
(440) 453-0754
Entity
Organization
Contact information
Practice address
415 FRONT ST, BEREA, OH 44017-1716
(315) 383-3225
Mailing address
415 FRONT ST, BEREA, OH 44017-1716
(315) 383-3225
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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