Organization
GREY SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH ELISE TIDWELL LPC (OWNER)
(205) 202-1883
Entity
Organization
Contact information
Practice address
6001 OLD LEEDS RD, IRONDALE, AL 35210-4292
(205) 202-1883
Mailing address
429 GREEN SPRINGS HWY STE 161-367, BIRMINGHAM, AL 35209-4935
(205) 202-1883
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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