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Organization
SOUL SPACE THERAPY, LLC
Active
Organization
SOUL SPACE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANIE JANINE BRYNOLF LCSW, CAC (OWNER/CLINICAL THERAPIST)
(810) 845-6090
Entity
Organization
Contact information
Practice address
25078 PURPLE EMPEROR WAY, PUNTA GORDA, FL 33955-6220
(810) 845-6090
(941) 467-1723
Mailing address
25078 PURPLE EMPEROR WAY, PUNTA GORDA, FL 33955-6220
(810) 845-6090
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/13/2018
Last updated
10/27/2021
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