Individual
MS. AMY SPACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.P.C.
Contact information
Practice address
314 E HIGHLAND MALL BLVD STE 260.14, AUSTIN, TX 78752-3735
(512) 426-2145
Mailing address
8601 ANDERSON MILL RD, AUSTIN, TX 78729-4700
(512) 426-2145
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
66918
TX
Other
Enumeration date
10/17/2012
Last updated
10/23/2012
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