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Organization
THESPACEBETWEENPSYCHOTHERAPY, LLC
Active
Organization
THESPACEBETWEENPSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA BETH DILLENBECK MS,NCC, LCPC, CAC-AD (SOLE MBR)
(443) 398-1700
Entity
Organization
Contact information
Practice address
605 N BENTZ ST, SUITE 204, FREDERICK, MD 21701-4982
(443) 398-1700
Mailing address
605 N BENTZ ST, SUITE 204, FREDERICK, MD 21701-4982
(443) 398-1700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC6977
MD
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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