Provider Demographics
NPI:1154709897
Name:KREATIVE KIDS THERAPY
Entity type:Organization
Organization Name:KREATIVE KIDS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-305-9665
Mailing Address - Street 1:1171 NW 124TH AVE
Mailing Address - Street 2:SUITE 131
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8660 W FLAGLER ST
Practice Address - Street 2:SUITE 131
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2031
Practice Address - Country:US
Practice Address - Phone:305-305-9665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 14043224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty