Provider Demographics
NPI:1609573112
Name:A SPACE TO REFLECT, THERAPY AND COACHING LLC
Entity Type:Organization
Organization Name:A SPACE TO REFLECT, THERAPY AND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGARAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:267-239-6470
Mailing Address - Street 1:1428 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5928
Mailing Address - Country:US
Mailing Address - Phone:267-225-4428
Mailing Address - Fax:
Practice Address - Street 1:1428 S 4TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5928
Practice Address - Country:US
Practice Address - Phone:267-225-4428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty