Organization
SACRED SPACE PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES HERNANDEZ PSY.D. (PSYCHOLOGIST/OWNER)
(504) 231-9274
Entity
Organization
Contact information
Practice address
206 S TYLER ST STE B, COVINGTON, LA 70433-3073
(504) 231-9274
Mailing address
206 S TYLER ST STE B, COVINGTON, LA 70433-3073
(504) 231-9274
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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