MEDICARE: ROOTED MOTHER & INFANT CARE, LLC

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	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1417898057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTED MOTHER & INFANT CARE, LLC

Provider Business Mailing Address
First Line	:	7645 TURTLE CREEK DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-1755
Country	:	US
Telephone Number	:	440-313-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	7645 TURTLE CREEK DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-1755
Country	:	US
Telephone Number	:	440-313-8530
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MELISSA ADRIAN
Credential	:	OTD, OTR/L
Telephone Number	:	440-313-8530

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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