| Holding Space Therapy, Llc | |
|
N2440 Ara Glen Dr Ste 203 Lake Geneva WI 53147-3736 | |
| (651) 564-8456 | |
| Not Available |
| Full Name | Holding Space Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | N2440 Ara Glen Dr Ste 203, Lake Geneva, Wisconsin |
| Authorized Official Name and Position | Candace Rutkowski (MARRIAGE AND FAMILY THERAPIST) |
| Authorized Official Contact | 6515648456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holding Space Therapy, Llc N2440 Ara Glen Dr Ste 203 Lake Geneva WI 53147-3736 Ph: (651) 564-8456 | Holding Space Therapy, Llc N2440 Ara Glen Dr Ste 203 Lake Geneva WI 53147-3736 Ph: (651) 564-8456 |
| NPI Number | 1275157224 |
|---|---|
| Provider Enumeration Date | 06/05/2020 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275157224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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