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General NPI Number Information
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NPI Number | 1609739317
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC ESCAPE SPACE PLLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 18924 KUYKENDAHL RD STE B
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City | SPRING
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State | TX
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Zip | 77379-5585
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Country | US
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Telephone | 346-525-4981
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Fax |
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Provider Business Mailing Address
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Address Line | 18924 KUYKENDAHL RD STE B
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City | SPRING
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State | TX
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Zip | 77379-5585
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Country | US
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Telephone | 346-525-4981
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. MARTICA LAVETTE SHERMAN
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Credential | LPC
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Telephone | 346-525-4981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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