Space for Change Therapeutic Services, LLC

NPI #1740957133 in Jenison, Michigan

Provider Information

NPI Number: 1740957133
Entity Type: Organization
Organization Name: Space for Change Therapeutic Services, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 24, 2021
Last Updated: Aug 24, 2021

Practice Location

Address: 1352 BALDWIN ST
City: Jenison
State: Michigan
ZIP Code: 49428-8937
Phone: (616) 322-3803

Authorized Official

Name: TASHUNA HUNT, LMSW
Title: LEAD THERAPIST
Phone: (616) 322-3803

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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