| Growth Space, Pllc | |
|
100 Independence Pl Ste 201 Tyler TX 75703-1327 | |
| (903) 224-2262 | |
| Not Available |
| Full Name | Growth Space, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 100 Independence Pl Ste 201, Tyler, Texas |
| Authorized Official Name and Position | Katherine Stanglin (OWNER, THERAPIST) |
| Authorized Official Contact | 9032242262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth Space, Pllc 6417 Penn Ave S Ste 7-216 Minneapolis MN 55423-1186 Ph: (903) 224-2262 | Growth Space, Pllc 100 Independence Pl Ste 201 Tyler TX 75703-1327 Ph: (903) 224-2262 |
| NPI Number | 1225889868 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/01/2024 |
| Certification Date | 03/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225889868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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