| NPI | 1427673367 |
|---|---|
| Former Legal Business Name | KEZIA E COLEMAN PSYD LLC |
| Doing Business As | HEALING SPACES PSYCHOLOGICAL SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | KEZIA JACKSON Owner 314-472-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-09-21 |