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Organization

WIDE SPACES PLLC

Active
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Organization

WIDE SPACES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMARA PAYDEN TRAVERS MCLAUGHLIN MSW, LCSWA (OWNER/CLINICIAN)
(336) 473-1575
Entity
Organization

Contact information

Practice address
221 E SPRAGUE ST, WINSTON SALEM, NC 27127-3013
(336) 496-1621
Mailing address
221 E SPRAGUE ST, WINSTON SALEM, NC 27127-3013

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
04/02/2025
Last updated
04/02/2025
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