Healthcare Provider Details

I. General information

NPI: 1457207169
Provider Name (Legal Business Name): THE RELATIONAL SPACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 NORTH BLVD
PORT HURON MI
48060-6985
US

IV. Provider business mailing address

2529 NORTH BLVD
PORT HURON MI
48060-6985
US

V. Phone/Fax

Practice location:
  • Phone: 810-689-4733
  • Fax:
Mailing address:
  • Phone: 810-689-4733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER RITCHIE
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LMSW, CAADC
Phone: 810-689-4733