Organization
HEART SPACE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLIE CARPENTER (CREDENTIALING)
(978) 906-0418
Entity
Organization
Contact information
Practice address
1962 MAE ST, ASHLAND, OR 97520-2523
(805) 750-2433
Mailing address
401 NE 19TH AVE STE 200, PORTLAND, OR 97232-4800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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