Soulful Spaces Therapy Pllc
NPI #1255174447 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1255174447
- Entity Type
- Organization
- Organization Name
- Soulful Spaces Therapy Pllc
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Jun 14, 2024
- Last Updated
- Jul 12, 2024
Practice Location
- Address
- 1400 EBERHART AVE
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-1013
- Phone
- (217) 871-1089
Authorized Official
- Name
- SHYANNA KIRBY, LCSW
- Title
- OWNER
- Phone
- (217) 871-1089
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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