| Divine Healing Space, Pllc | |
|
12222 Merit Dr # 130 Dallas TX 75251-2217 | |
| (504) 410-0031 | |
| Not Available |
| Full Name | Divine Healing Space, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 12222 Merit Dr # 130, Dallas, Texas |
| Authorized Official Name and Position | Jasmine Battles (OWNER/ CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5044100031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Healing Space, Pllc 12222 Merit Dr # 130 Dallas TX 75251-2217 Ph: (504) 410-0031 | Divine Healing Space, Pllc 12222 Merit Dr # 130 Dallas TX 75251-2217 Ph: (504) 410-0031 |
| NPI Number | 1417521907 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 05/18/2021 |
| Certification Date | 05/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417521907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
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