Healthcare Provider Details
I. General information
NPI: 1285570861
Provider Name (Legal Business Name): ROOTED BEHAVIOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 TALL OAKS DR
HOCKESSIN DE
19707-2041
US
IV. Provider business mailing address
22 TALL OAKS DR
HOCKESSIN DE
19707-2041
US
V. Phone/Fax
- Phone: 302-270-0107
- Fax:
- Phone: 302-270-0107
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JESSICA
STUHLTRAGER
Title or Position: OWNER/FOUNDER
Credential: BCBA
Phone: 302-270-0107