| Creative Roots Therapy Llc | |
|
375 Park Ave Suite B Coos Bay OR 97420 | |
| (541) 808-4719 | |
| Not Available |
| Full Name | Creative Roots Therapy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 375 Park Ave, Coos Bay, Oregon |
| Authorized Official Name and Position | Erin Elizabeth Spier (OWNER/THERAPIST) |
| Authorized Official Contact | 5418084719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Roots Therapy Llc Po Box 576 Coos Bay OR 97420 Ph: (541) 808-4719 | Creative Roots Therapy Llc 375 Park Ave Suite B Coos Bay OR 97420 Ph: (541) 808-4719 |
| NPI Number | 1144607961 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 07/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144607961 | NPI | - | NPPES |
| 500673890 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C3450 (Oregon) | Primary |
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