| Connected Space Counseling, Llc | |
|
1201 Se 223rd Ave Ste 165 Gresham OR 97030-2577 | |
| (971) 404-4668 | |
| (971) 273-2708 |
| Full Name | Connected Space Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1201 Se 223rd Ave Ste 165, Gresham, Oregon |
| Authorized Official Name and Position | Frances Leanne Clark (OWNER) |
| Authorized Official Contact | 5034441190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connected Space Counseling, Llc 1201 Se 223rd Ave Ste 165 Gresham OR 97030-2577 Ph: (971) 404-4668 | Connected Space Counseling, Llc 1201 Se 223rd Ave Ste 165 Gresham OR 97030-2577 Ph: (971) 404-4668 |
| NPI Number | 1194433250 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194433250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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