Organization
HEALING SPACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA JOHNSON (OWNER/PRINCIPAL)
(404) 538-3387
Entity
Organization
Contact information
Practice address
3883 ROGERS BRIDGE RD, STE. 203A, DULUTH, GA 30097-2802
(404) 538-3387
Mailing address
1938 JOHNSON FERRY RD NE, UNIT G, BROOKHAVEN, GA 30319-5011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC007987
GA
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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