| Inner Spark Therapy Llc | |
|
134 S Wasson St Coos Bay OR 97420-3235 | |
| (971) 266-4355 | |
| Not Available |
| Full Name | Inner Spark Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 134 S Wasson St, Coos Bay, Oregon |
| Authorized Official Name and Position | Corina Daugherty Calhoun (OWNER, THERAPIST) |
| Authorized Official Contact | 9712664355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Spark Therapy Llc 1995 Newmark Ave # 1012 Coos Bay OR 97420-4727 Ph: () - | Inner Spark Therapy Llc 134 S Wasson St Coos Bay OR 97420-3235 Ph: (971) 266-4355 |
| NPI Number | 1295519312 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 08/21/2023 |
| Certification Date | 08/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295519312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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