The Grace Space, Llc.

NPI #1811733074 in Bastrop, Louisiana

Provider Information

NPI Number: 1811733074
Entity Type: Organization
Organization Name: The Grace Space, Llc.
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 6, 2024
Last Updated: Jul 6, 2024

Practice Location

Address: 6308 ESTATES DR
City: Bastrop
State: Louisiana
ZIP Code: 71220-9748
Phone: (318) 417-9046

Authorized Official

Name: MRS. DENITRA BEASLEY, LPC
Title: OWNER
Phone: (318) 417-9046

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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