MEDICARE: RICH ROOTS 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

General Provider Information

NPI Number	:	1780531855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICH ROOTS PLLC

Provider Business Mailing Address
First Line	:	4295 LEEDSTOWN RD
Second Line	:
City	:	COLONIAL BEACH
State	:	VA
Zip	:	22443-5408
Country	:	US
Telephone Number	:	804-313-5228
Fax Number	:

Provider Business Practice Location Address
First Line	:	4295 LEEDSTOWN RD
Second Line	:
City	:	COLONIAL BEACH
State	:	VA
Zip	:	22443-5408
Country	:	US
Telephone Number	:	804-313-5228
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	BRIANA RICHARDS
Credential	:
Telephone Number	:	804-313-5228

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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