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General NPI Number Information
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NPI Number | 1043029309
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Entity Type | Organization
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Legal Business Name | LOTUS SPACE LLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 701 E CATHEDRAL RD 45 1338
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2128
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Country | US
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Telephone | 215-839-6096
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Fax |
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Provider Business Mailing Address
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Address Line | 701 E CATHEDRAL RD
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2128
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Country | US
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Telephone | 215-839-6096
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Fax |
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST
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Name | JAMILIA PARKER
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Credential | LMFT
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Telephone | 215-839-6096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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