IndividualActive
Thereasa Space, PA(ASCP)
NPI 1710604863 · Pathology Specialist/Technologist · Munster, IN
Provider details
- NPI number
- 1710604863
- Entity type
- Individual
- Primary specialty
- Pathology Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers
- Credential
- PA(ASCP)
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
901 Macarthur Blvd
Munster, IN 46321-2901
Phone: (219) 703-1784
Approximate (ZIP-level) locationGet directions
Mailing address
2417 Indiana Ave
Lansing, IL 60438
Registry dates
- Enumerated
- 2022-10-19
- Last updated
- 2022-10-19
- Certified
- 2022-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.