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General NPI Number Information
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NPI Number | 1659112381
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Entity Type | Organization
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Legal Business Name | A SAFE SPACE INDIVIDUAL FAMILY AND MARRIAGE TELEHEALTH COUNSELING
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 30914 PALETTE RD
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City | MURRIETA
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State | CA
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Zip | 92563-1185
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Country | US
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Telephone | 951-966-7893
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Fax |
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Provider Business Mailing Address
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Address Line | 27890 CLINTON KEITH ROAD SUITE D #167
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City | MURRIETA
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State | CA
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Zip | 92562-8572
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Country | US
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Telephone | 951-966-7893
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | MRS. SHERRY M MORRIS
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Credential |
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Telephone | 951-966-7893
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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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