Organization
CREATIVE PLAY AND SPEECH THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC VIANELLE M.S. CCC-SLP (DIRECTOR)
(916) 267-7262
Entity
Organization
Contact information
Practice address
1425 N KILLINGSWORTH ST, PORTLAND, OR 97217-4541
(916) 267-7262
Mailing address
905 NE FRANKLIN AVE, BEND, OR 97701-4927
(916) 267-7262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015101
OR
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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