| Creating Space Therapy Pllc | |
|
12020 Sunrise Valley Dr Ste 100 Reston VA 20191-3429 | |
| (571) 241-3915 | |
| Not Available |
| Full Name | Creating Space Therapy Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 12020 Sunrise Valley Dr Ste 100, Reston, Virginia |
| Authorized Official Name and Position | Sonia Castro-castillo (OWNER) |
| Authorized Official Contact | 5712413915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creating Space Therapy Pllc 12020 Sunrise Valley Dr Ste 100 Reston VA 20191-3429 Ph: (571) 241-3915 | Creating Space Therapy Pllc 12020 Sunrise Valley Dr Ste 100 Reston VA 20191-3429 Ph: (571) 241-3915 |
| NPI Number | 1134998982 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 12/22/2023 |
| Certification Date | 12/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134998982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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