| Soulspace Counseling Llc | |
|
28 Roseleah Dr Waterford CT 06385-4310 | |
| (860) 941-4743 | |
| (860) 941-4743 |
| Full Name | Soulspace Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 28 Roseleah Dr, Waterford, Connecticut |
| Authorized Official Name and Position | Mariah Fairley (OWNER) |
| Authorized Official Contact | 8609414743 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulspace Counseling Llc 28 Roseleah Dr Waterford CT 06385-4310 Ph: (860) 941-4743 | Soulspace Counseling Llc 28 Roseleah Dr Waterford CT 06385-4310 Ph: (860) 941-4743 |
| NPI Number | 1811726482 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 08/04/2024 |
| Certification Date | 08/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811726482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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