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Organization
LAVENDER SPACE, INC
Active
Organization
LAVENDER SPACE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARYN THOMPSON LCSW-S (OWNER/PSYCHOTHERAPIST)
(512) 831-6696
Entity
Organization
Contact information
Practice address
100 E SAN ANTONIO ST STE 101, SAN MARCOS, TX 78666-5568
(512) 831-6696
Mailing address
100 E SAN ANTONIO ST STE 101, SAN MARCOS, TX 78666-5568
(512) 831-6696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174179212
NPPES
TX
Enumeration date
11/08/2024
Last updated
11/08/2024
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