| The Well Space Therapy, Pllc | |
|
23712 105th St Se Monroe WA 98272-8748 | |
| (425) 409-9671 | |
| Not Available |
| Full Name | The Well Space Therapy, Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 23712 105th St Se, Monroe, Washington |
| Authorized Official Name and Position | Tahani Daugherty (MANAGING MEMBER) |
| Authorized Official Contact | 4254099671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Well Space Therapy, Pllc 23712 105th St Se Monroe WA 98272-8748 Ph: (425) 409-9671 | The Well Space Therapy, Pllc 23712 105th St Se Monroe WA 98272-8748 Ph: (425) 409-9671 |
| NPI Number | 1407563653 |
|---|---|
| Provider Enumeration Date | 10/27/2022 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407563653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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