Organization
A SPACE FOR HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE ANNE VAVRO LISW (TRAUMA THERAPIST)
(440) 413-4637
Entity
Organization
Contact information
Practice address
8500 STATION ST STE 300J, MENTOR, OH 44060-4963
(440) 721-8979
Mailing address
8500 STATION STREET, STE 300J, MENTOR, OH 44060-5756
(407) 218-9794
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
09/23/2024
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