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Organization

RELATESPACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE LOU PSYD (SOLE MEMBER AND OWNER)
(617) 366-2550
Entity
Organization

Contact information

Practice address
75 ARLINGTON ST FL 5, BOSTON, MA 02116-3936
(617) 366-2550
Mailing address
8709 BRAY VISTA WAY, ELK GROVE, CA 95624-1713
(617) 366-2550
(617) 340-3733

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110119105A
MA
Enumeration date
04/30/2020
Last updated
01/07/2023
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