| 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 |
|---|---|
| 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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