Organization
HEART SPACE COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRIE MAE KING OT (MEMBER)
(903) 692-3463
Entity
Organization
Contact information
Practice address
649 COUNTY ROAD 433, TENAHA, TX 75974-6332
(903) 692-3463
Mailing address
PO BOX 1515, CARTHAGE, TX 75633-7515
(903) 692-3463
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106894
TX
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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