Provider Demographics
NPI:1710396122
Name:THE ART THERAPY STUDIO
Entity type:Organization
Organization Name:THE ART THERAPY STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CREATIVE ARTS THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCAT, ATRBC
Authorized Official - Phone:716-225-0700
Mailing Address - Street 1:108 S ALBANY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5446
Mailing Address - Country:US
Mailing Address - Phone:716-225-0700
Mailing Address - Fax:
Practice Address - Street 1:108 S ALBANY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5446
Practice Address - Country:US
Practice Address - Phone:716-225-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001526-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty