| Southern Illinois Center For Art & Play Therapy Llc | |
|
105 N Emerald Ln Suite C Carbondale IL 62901-2168 | |
| (618) 534-3393 | |
| (618) 457-7736 |
| Full Name | Southern Illinois Center For Art & Play Therapy Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 105 N Emerald Ln, Carbondale, Illinois |
| Authorized Official Name and Position | Katherine Schwartz (OWNER/COUNSELOR) |
| Authorized Official Contact | 6185343393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Center For Art & Play Therapy Llc 105 N Emerald Ln Suite C Carbondale IL 62901-2168 Ph: (618) 534-3393 | Southern Illinois Center For Art & Play Therapy Llc 105 N Emerald Ln Suite C Carbondale IL 62901-2168 Ph: (618) 534-3393 |
| NPI Number | 1740521285 |
|---|---|
| Provider Enumeration Date | 03/08/2013 |
| Last Update Date | 03/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740521285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180.008512 (Illinois) | Primary |
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