Organization
SOULSPACE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA CARULLI MA, LPC (OWNER / PSYCHOTHERAPIST)
(248) 397-5080
Entity
Organization
Contact information
Practice address
1026 W 11 MILE RD, ROYAL OAK, MI 48067-5401
(248) 397-5080
Mailing address
1923 ARDMORE AVE, ROYAL OAK, MI 48073-4179
(248) 824-4085
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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