Space For Change Therapeutic Services, Llc | |
1352 Baldwin St Jenison MI 49428-8937 | |
(616) 322-3803 | |
Not Available |
Full Name | Space For Change Therapeutic Services, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 1352 Baldwin St, Jenison, Michigan |
Authorized Official Name and Position | Tashuna Hunt (LEAD THERAPIST) |
Authorized Official Contact | 6163223803 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Space For Change Therapeutic Services, Llc 1352 Baldwin St Jenison MI 49428-8937 Ph: (616) 322-3803 | Space For Change Therapeutic Services, Llc 1352 Baldwin St Jenison MI 49428-8937 Ph: (616) 322-3803 |
NPI Number | 1740957133 |
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Provider Enumeration Date | 08/24/2021 |
Last Update Date | 08/24/2021 |
Certification Date | 08/24/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740957133 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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