| Your Space Therapy, Pllc | |
|
411 Monroe St Petoskey MI 49770-2234 | |
| (231) 753-6462 | |
| Not Available |
| Full Name | Your Space Therapy, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 411 Monroe St, Petoskey, Michigan |
| Authorized Official Name and Position | Amber L Merrow (OWNER) |
| Authorized Official Contact | 8102100953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Space Therapy, Pllc 411 Monroe St Petoskey MI 49770-2234 Ph: (231) 753-6462 | Your Space Therapy, Pllc 411 Monroe St Petoskey MI 49770-2234 Ph: (231) 753-6462 |
| NPI Number | 1356057939 |
|---|---|
| Provider Enumeration Date | 01/26/2023 |
| Last Update Date | 02/04/2023 |
| Certification Date | 02/04/2023 |
| Medicare PECOS PAC ID | 5092161901 |
|---|---|
| Medicare Enrollment ID | O20231030001906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356057939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amber Lynn Merrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578979142 PECOS PAC ID: 6901252816 Enrollment ID: I20231030002119 |
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