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1295519312
INNER SPARK THERAPY LLC
COOS BAY, OR
NPI
1295519312
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Entity Type
Organization
Authorized Contact
CORINA DAUGHERTY CALHOUN
Owner, Therapist
971-266-4355
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
INNER SPARK THERAPY LLC
134 S WASSON ST
COOS BAY, OR 97420-3235
Phone number: 971-266-4355
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Mailing Address
INNER SPARK THERAPY LLC
1995 NEWMARK AVE # 1012
COOS BAY, OR 97420-4727
Phone number:
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