Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Counselor |
101Y00000X | |||
Mental Health |
101YM0800X | |||
School |
101YS0200X |
| NPI Number | 1821352121 |
||||||||
| LBN Legal business name | ART OF CREATIVE DIMENSIONS, INC., THE | ||||||||
| Authorized official | KEILA KILGORE - (LICENSED PROFESSIONAL COUNSELOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 07/02/2012 | ||||||||
| Last updated | 07/02/2012 - About 14 years ago | ||||||||
| Identifiers |
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