| NPI | 1215485537 |
|---|---|
| Doing Business As | SACRED SPACE PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | TERYN ANDY Owner/Psychiatric Nurse Practitione 860-798-8158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2025-08-21 |