MEDICARE: ROOTED THERAPIES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1295448736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTED THERAPIES, PLLC

Provider Business Mailing Address
First Line	:	9353 GRANGER LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6153
Country	:	US
Telephone Number	:	972-743-1270
Fax Number	:

Provider Business Practice Location Address
First Line	:	9353 GRANGER LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6153
Country	:	US
Telephone Number	:	972-743-1270
Fax Number	:

Authorized Official
Title or Position	:	OWNER, SLP
Name	:	RACHEL TERRELL
Credential	:	M.S. CCC-SLP
Telephone Number	:	972-743-1270

Provider Enumeration Date	:	12/29/2022
Last Update Date	:	09/05/2025

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