Organization
THE THERAPY SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA L EVANS LPC (OWNER)
(267) 254-1175
Entity
Organization
Contact information
Practice address
1084 E LANCASTER AVE STE 301, BRYN MAWR, PA 19010-1515
(267) 254-1175
Mailing address
8201 HENRY AVE APT Q9, PHILADELPHIA, PA 19128-2250
(267) 254-1175
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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