| Spiritspace, Inc. | |
|
305 Moody Ave Suite 243 Galveston TX 77550-1696 | |
| (409) 765-6093 | |
| (409) 765-6093 |
| Full Name | Spiritspace, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 305 Moody Ave, Galveston, Texas |
| Authorized Official Name and Position | Mary Kay Sandor (PRESIDENT) |
| Authorized Official Contact | 4097656093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spiritspace, Inc. 2228 Mechanic St Suite 306 Galveston TX 77550-1592 Ph: (409) 765-6093 | Spiritspace, Inc. 305 Moody Ave Suite 243 Galveston TX 77550-1696 Ph: (409) 765-6093 |
| NPI Number | 1659645067 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 08/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659645067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 14440 (Texas) | Primary |
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