# HEART SPACE COUNSELING CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861752750
- **Authorized official:** TERRIE MAE KING OT (MEMBER)
- **Authorized official phone:** (903) 692-3463

## Contact information

- **Practice address:** 649 COUNTY ROAD 433, TENAHA, TX 75974-6332
- **Practice address phone:** (903) 692-3463
- **Mailing address:** PO BOX 1515, CARTHAGE, TX 75633-7515
- **Mailing address phone:** (903) 692-3463

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 106894 | TX | Yes |

## Other

- **Enumeration date:** 05/24/2012
- **Last updated:** 05/24/2012